Appendix 1: Malaria transmission and recommended preventive measures by geographical area
Last full appendix update: March 2024
Table of contents
- Description
- Appendix 1: Malaria Transmission and Recommended Preventive Measures by Geographical Area
- References
Description
Appendix I is a country-by-country description of malaria transmission and recommendations for malaria prevention. As appropriate, regional and/or city-specific and/or seasonality risk information is also provided. The recommendations made in this appendix are generally consistent with the World Health Organization's International Travel and Health report and the CDC's Yellow Book: Health Information for International Travel. These and other sources used to develop this appendix are listed in the references.
While this appendix is updated regularly, it is possible that it will not reflect the most up-to-date information about malaria for a country, e.g., recent cases in a hitherto malaria-free jurisdiction. For this reason, health care providers providing advice on malaria prevention are encouraged to visit the Public Health Agency of Canada's Travel Health website to monitor for the newest information related to malaria and other travel-associated health risks.
For certain countries, there is a duration-of-exposure component to recommendations, expressed as: “Travellers spending extended periods in [transmission areas] may consider chemoprophylaxis.” The intent of this approach is to allow for greater flexibility in areas where malaria transmission is low.
The appendix includes information on species of malaria parasite present in endemic countries, described as Plasmodium falciparum (P. f.), Plasmodium vivax (P. vivax), Plasmodium ovale (P. ovale), Plasmodium malariae (P. malariae) and/or Plasmodium knowlesi (P. knowlesi). The most common species is listed first and indicated in bold (if several species predominate, then they are bolded), followed by the second most frequent species, often P. vivax, and then, if additional species are present, they are identified by an *. The exception is P. knowlesi, which is always identified where it is thought to present a hazard.
Notes
- Countries categorized as having no malaria transmission have no record of recent local transmission, or are reporting very limited sporadic local transmission.
- Chemoprophylaxis is recommended only in the risk areas identified. Chemoprophylaxis should always be used in conjunction with personal protective measures (PPM); refer to Chapter 3: "Malaria Education for Travellers" and the CATMAT Statement on Personal Protective Measures to Prevent Arthropod Bites).
- The decision whether to use atovaquone-proguanil, doxycycline or mefloquine should be based on an individual patient benefit - risk assessment.
- There might be situations where alternative agents are considered, e.g., primaquine. Refer to Chapter 8: "Drugs for the Prevention and Treatment of Malaria" for advice in this regard. Primaquine for presumptive anti-relapse therapy is not considered in this table (and is rarely recommended, see Chapter 8).
Appendix 1: Malaria transmission and recommended preventive measures by geographical area
| Country | Malaria transmission areas and other information | Species of parasite present (more common in bold) |
Malaria prevention recommendation |
|---|---|---|---|
Afghanistan |
Transmission occurs in all areas at elevations < 2500 m. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
Albania |
No malaria transmission. |
n/a |
None. |
Algeria |
No malaria transmission. |
n/a |
None. |
American Samoa |
No malaria transmission. |
n/a |
None. |
Andorra |
No malaria transmission. |
n/a |
None. |
Angola |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Anguilla (UK) |
No malaria transmission. |
n/a |
None. |
Antigua and Barbuda |
No malaria transmission. |
n/a |
None. |
Argentina |
No malaria transmission. |
n/a |
None. |
Armenia |
No malaria transmission. |
n/a |
None. |
Aruba (NL) |
No malaria transmission. |
n/a |
None. |
Australia |
No malaria transmission. |
n/a |
None. |
Austria |
No malaria transmission. |
n/a |
None. |
Azerbaijan |
Certified malaria-free in 2023. |
n/a |
None. |
Bahamas |
No malaria transmission. |
n/a |
None. |
Bahrain |
No malaria transmission. |
n/a |
None. |
Bangladesh |
No transmission in the city of Dhaka. |
n/a |
None. |
Little to no transmission in areas of the country not described below. |
P. f. |
PPM. |
|
Transmission occurs in the Chattogram Division, including the Chittagong Hill Tract districts (Bandarban, Rangamati and Khagrachari), Cox's Bazaar, and the districts of Hobigonj, Kurigram, Moulvibazar, Mymensingh, Netrakona, Sherpur, Sunamgonj and Sylhet. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Barbados |
No malaria transmission. |
n/a |
None. |
Belarus |
No malaria transmission. |
n/a |
None. |
Belgium |
No malaria transmission. |
n/a |
None. |
Belize |
Certified malaria-free in 2023. |
n/a |
None. |
Benin |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Bermuda (UK) |
No malaria transmission. |
n/a |
None. |
Bhutan |
Low transmission in parts of the country, in rural areas <1700 m, and in districts along the southern border shared with India. |
P. vivax |
PPM. |
Bolivia (Plurinational State of) |
No transmission in areas at elevations ≥ 2500 m. |
n/a |
None. |
Transmission occurs in all areas at elevations < 2500 m. The risk is predominantly due to P. vivax, with exceptions listed below. Transmission of P. f. occurs in the northern departments of Beni and Pando (especially in the localities of Guayaramerín, Riberalta, and Sena). |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Bosnia and Herzegovina |
No malaria transmission. |
n/a |
None. |
Botswana |
No transmission in the city of Gaborone, or in other areas not listed below. |
n/a |
None. |
Low transmission in the districts of Kgalagadi North, Kweneng West, and Southern. |
P. f. |
PPM. |
|
Transmission occurs in the following districts/sub-districts: Central, Kweneng East, North-East (including Francistown), North-West (including Chobe National Park), and Okavango delta. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Brazil |
Some cases of P.vivax have been reported in 2018, in the town of Wenceslau Guimarães in Bahia State. Little to no transmission in the states outside the administrative region of Amazonas, including Iguazu Falls, in the urban areas of Brasília, Recife, Rio de Janeiro, São Paulo, and Salvador. Low transmission in the less forested areas in southern Mato Grosso, including most of the Pantanal. |
P. vivax |
PPM. |
There is residual transmission of P. vivax in the Atlantic Forest areas of the states of Espirito Santo, Minas Gerais, Rio de Janeiro, and São Paulo. |
PPM. |
||
Transmission occurs in most forested areas within the nine states of the Amazon region (Acre, Amapá, Amazonas, Maranhão [western part], Mato Grosso [northern part]), Pará [except Belém City], Rondônia, Roraima and Tocantins [western part]). Transmission intensity varies from one municipality to another, and is higher in jungle mining areas, in agricultural settlements, in indigenous areas and in some peripheral urban areas of Cruzeiro do Sul, Manaus, Maraba, and Pôrto Velho. Transmission also occurs on the periphery of large urban areas such as Boa Vista, Macapá, Rio Branco, and Santarém. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
British Virgin Islands (UK) |
No malaria transmission. |
n/a |
None. |
Brunei Darussalam |
Human infection with P. knowlesi reported in forested areas. |
n/a |
PPM. Travellers spending extended periods in rural or forested areas may consider chemoprophylaxis: atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
Bulgaria |
No malaria transmission. |
n/a |
None. |
Burkina Faso |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Burundi |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Cabo Verde |
Certified malaria-free in 2024. |
n/a |
None. |
Cambodia |
No transmission in the cities of Phnom Penh and Siem Reap. |
n/a |
None. |
Low transmission in the tourist area of Angkor Wat and around Lake Tonlé Sap. |
P. vivax |
PPM. |
|
Transmission occurs in all other areas not listed above. P. falciparum resistance to mefloquine has been reported in western Cambodia and extends to the centre of the country. For post-travel care, P. falciparum resistance to artesunate, lumefantrine, and piperaquine has been reported in western Cambodia and extends to the centre of the country. P. vivax resistance to chloroquine has been reported in eastern Cambodia. |
Atovaquone-proguanil or doxycycline. |
||
Cameroon |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Canada |
No malaria transmission. |
n/a |
None. |
Cayman Islands (UK) |
No malaria transmission. |
n/a |
None. |
Central African Republic |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Chad |
All areas, except in the Sahara Desert. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Chile |
No malaria transmission. |
n/a |
None. |
China |
Certified malaria-free in 2021. |
n/a |
None. |
Colombia |
No transmission in areas ≥ 1700 m, including Bogota, and in the urban areas of Baranquilla, Cartagena, and on the islands of San Andres and Providencia. |
n/a |
None. |
Little to no transmission in northern rural areas and along the Caribbean coast. |
P. f. |
PPM. |
|
Transmission occurs in rural and jungle areas <1700 m, and on excursions on the Magdalena River south of Baranquilla, on the Pacific coast, in the valleys of the Andes, and east of the Cordillera Oriental. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Comoros |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Congo |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Congo, Democratic Republic of the (formerly Zaïre) |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Cook Islands (NZ) |
No malaria transmission. |
n/a |
None. |
Costa Rica |
Little to no transmission in areas not listed below. |
P. f. |
PPM. |
Transmission occurs in Alajuela Province near the border with Nicaragua and in Limón Province. |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
||
Côte D'Ivoire (Ivory Coast) |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Croatia |
No malaria transmission. |
n/a |
None. |
Cuba |
No malaria transmission. |
n/a |
None. |
Curaçao (NL) |
No malaria transmission. |
n/a |
None. |
Cyprus |
No malaria transmission. |
n/a |
None. |
Czechia |
No malaria transmission. |
n/a |
None. |
Denmark |
No malaria transmission. |
n/a |
None. |
Djibouti |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Dominica |
No malaria transmission. |
n/a |
None. |
Dominican Republic |
Little to no transmission through most of the country including resort areas. Sporadic cases among travellers are possible given the very large travel volume to the Dominican Republic but generally does not warrant a change in approach to prevention. |
P. f. |
PPM. |
Transmission occurs in the following provinces bordering Haiti: Dajabón, Elias Piña, and San Juan. |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
||
Ecuador |
Little to no transmission in the urban areas of Guayaquil or on the Galápagos Islands, and at elevations ≥ 1500 m, including Cuenca, Quito, and other urban areas and villages in the Andean highlands. |
P. vivax |
PPM. |
Transmission occurs in areas at elevations < 1500 m, including the provinces of Esmeraldas, Morona-Santiago, Orellana, Pastaza, Sucumbíos, and in the provinces of Carchi and Cotopaxi. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Egypt |
No malaria transmission. |
n/a |
None. |
El Salvador |
Certified malaria-free in 2021. |
n/a |
None. |
Equatorial Guinea |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Eritrea |
No transmission at elevations ≥ 2200 m, including the city of Asmara. |
n/a |
None. |
Transmission occurs in all areas at elevations < 2200 m. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Estonia |
No malaria transmission. |
n/a |
None. |
Ethiopia |
Little to no transmission at elevations ≥ 2500 m, and in the urban areas of Addis Ababa. |
n/a |
PPM. |
Transmission occurs in all areas at elevations < 2500 m, including Axum (2139 m), Dire Dawa (1262 m), Harar (1848 m), and Nazret (1725 m). |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Fiji |
No malaria transmission. |
n/a |
None. |
Finland |
No malaria transmission. |
n/a |
None. |
France |
No malaria transmission. |
n/a |
None. |
French Guiana |
No transmission in the city of Cayenne or on Devil's Island (Île du Diable). |
n/a |
None. |
Low transmission along the coast but increasing towards the interior. |
P. vivax |
PPM. |
|
Transmission occurs in all other areas, particularly along the rivers in the interior, in municipalities bordering Brazil (Oiapoque river valley) and Suriname (Maroni river valley); transmission also occurs in the communes of Kourou, Matoury, and Saint-Elie. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
French Polynesia |
No malaria transmission. |
n/a |
None. |
Gabon |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Gambia |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Georgia |
No malaria transmission. |
n/a |
None. |
Germany |
No malaria transmission. |
n/a |
None. |
Ghana |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Gibraltar (UK) |
No malaria transmission. |
n/a |
None. |
Greece |
Very limited local transmission associated with imported cases in agricultural areas. No transmission in tourist areas. |
P. vivax |
None. |
Greenland (Denmark) |
No malaria transmission. |
n/a |
None. |
Grenada |
No malaria transmission. |
n/a |
None. |
Guadeloupe (FR) |
No malaria transmission. |
n/a |
None. |
Guam (US) |
No malaria transmission. |
n/a |
None. |
Guatemala |
No transmission in urban areas or areas at elevations > 1500 m. No transmission in Guatemala City, Antigua, and Lake Atitlán. |
n/a |
None. |
Low transmission in the departments of Chiquimula, Zacapa, Baja Verapaz, San Marcos, Jutiapa, Jalapa, El Progreso, Santa Rosa, Guatemala, Chimaltenango, Huehuetenango, and Quiche. |
P. vivax |
PPM. |
|
Transmission occurs in the departments of Escuintla (municipalities of Gomera, Masagua, Santa Lucia Cotzumalguapa, and Tiquisate), Alta Verapaz (municipalities of Telemán, Panzós, and La Tinta), Petén, Suchitepéquez, Retalhuleu, and Izabal. |
Atovaquone-proguanil, chloroquine, |
||
Guinea |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Guinea-Bissau |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or |
Guyana |
Little to no transmission in the cities of Amsterdam and Georgetown. |
P. vivax |
PPM. |
Transmission occurs in all other areas. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Haiti |
All areas. |
P. f. |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
Holy See (Vatican City) |
No malaria transmission. |
n/a |
None. |
Honduras |
No transmission in the cities of Tegucigalpa and San Pedro Sula. |
n/a |
None. |
Transmission occurs throughout the country, including the island of Roatán and other Bay Islands. |
P. vivax |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
|
Hong Kong (China) |
No malaria transmission. |
n/a |
None. |
Hungary |
No malaria transmission. |
n/a |
None. |
Iceland |
No malaria transmission. |
n/a |
None. |
India |
No transmission at elevations > 2000 m, and in parts of the states of Himachal Pradesh, Jammu and Kashmir, and Sikkim. |
n/a |
None. |
Low transmission in the central urban areas of Delhi, Agra, Mumbai, Nagpur, Nasik, Pune, Kolkata, and Bangalore. |
P. f. |
PPM alone can be considered. If chemoprophylaxis is being considered: atovaquone-proguanil, doxycycline or mefloquine. |
|
Transmission occurs in all other areas. Transmission is relatively higher in the northeastern and central states, including Odisha, Chhattisgarh, Jharkhand, Madhya Pradesh, Maharashtra, and some north-eastern states such as Tripura, Meghalaya, and Mizoram. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Indonesia |
No transmission in the urban areas of Jakarta and Ubud, resort areas of Bali and Java, and Gili Islands and the Thousand Islands (Pulau Seribu). |
n/a |
None. |
Low transmission in the rural areas of Java, including Pangandaran, Sukalumi, and Ujung Kulong. |
P. f. |
PPM. |
|
Transmission occurs in all areas of eastern Indonesia (provinces of Maluku, Maluku Utara, Nusa Tenggara Timur, Papua, and Papua Barat), including the town of Labuan Bajo and Komodo Islands in the Nusa Tenggara region. Transmission also occurs in the rural areas of Kalimantan (Borneo), Nusa Tenggara Barat (including the island of Lombok), Sulawesi, and Sumatra. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Iran, Islamic Republic of |
Little to no transmission throughout most of the country. |
n/a |
PPM. |
Recent outbreaks in Sistan and Baluchestan Province, along the border with Pakistan. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Iraq |
No malaria transmission. |
n/a |
None. |
Ireland |
No malaria transmission. |
n/a |
None. |
Israel |
No malaria transmission. |
n/a |
None. |
Italy |
No malaria transmission. |
n/a |
None. |
Jamaica |
No malaria transmission. |
n/a |
None. |
Japan |
No malaria transmission. |
n/a |
None. |
Jordan |
No malaria transmission. |
n/a |
None. |
Kazakhstan |
No malaria transmission. |
n/a |
None. |
Kenya |
Little to no transmission at elevations ≥ 2500 m and in the urban areas of Nairobi. |
P. f. |
PPM. |
All other areas at elevations < 2500 m. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Kiribati |
No malaria transmission. |
n/a |
None. |
Korea, Democratic People's Republic of (North Korea) |
Little to no transmission in some southern areas. |
P. vivax |
PPM. |
Korea, Republic of (South Korea) |
Little to no transmission in the demilitarized zone (DMZ); rural areas in the northern parts of the provinces of Gyeonggi-do (Kyonggi) and Gangwon-do (Kangwon-do); and the northern part of the city of Incheon. |
P. vivax |
PPM. |
Kosovo |
No malaria transmission. |
n/a |
None. |
Kuwait |
No malaria transmission. |
n/a |
None. |
Kyrgyzstan |
No malaria transmission. |
n/a |
None. |
Lao People's Democratic Republic (Laos) |
No transmission in the city of Vientiane. |
n/a |
None. |
Transmission occurs in the rest of the country predominantly due to P. f. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Mefloquine resistance has been reported along the Laos-Myanmar border in the provinces of Bokeo and Louang Namtha, along the Laos-Thailand border in the province of Champasak and Saravan, along the Laos-Cambodia border, and along the Laos-Vietnam border. |
Atovaquone-proguanil or doxycycline. |
||
Latvia |
No malaria transmission. |
n/a |
None. |
Lebanon |
No malaria transmission. |
n/a |
None. |
Lesotho |
No malaria transmission. |
n/a |
None. |
Liberia |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Libya |
No malaria transmission. |
n/a |
None. |
Liechtenstein |
No malaria transmission. |
n/a |
None. |
Lithuania |
No malaria transmission. |
n/a |
None. |
Luxembourg |
No malaria transmission. |
n/a |
None. |
Macao (China) |
No malaria transmission. |
n/a |
None. |
Macedonia |
No malaria transmission. |
n/a |
None. |
Madagascar |
Little to no transmission in the urban areas of Antananarivo. |
P. f. |
PPM. |
All other areas. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Malawi |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Malaysia |
No transmission in urban, suburban, and coastal areas. |
n/a |
None. |
Transmission occurs in rural, forested areas. |
P. knowlesi |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
|
Maldives |
No malaria transmission. |
n/a |
None. |
Mali |
All areas, except in the Sahara Desert. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Malta |
No malaria transmission. |
n/a |
None. |
Marshall Islands |
No malaria transmission. |
n/a |
None. |
Martinique (FR) |
No malaria transmission. |
n/a |
None. |
Mauritania |
No transmission in the northern provinces of Dakhlet-Nouadhibou, Tiris-Zemmour, and in the Sahara Desert. |
n/a |
None. |
Transmission occurs in southern provinces, including Nouakchott. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Mauritius |
No malaria transmission. |
n/a |
None. |
Mayotte (FR) |
Little to no transmission in all areas. Mayotte is transitioning into an elimination phase. |
P. f. |
PPM. |
Mexico |
Little to no transmission in Campeche, Durango, Nayarit, Quintana Roo, Sinaloa, Sonora, and Tabasco. Recent small outbreak in Oaxaca. No malaria along the United States-Mexico border. |
P. vivax |
PPM. |
Low but possibly increasing transmission in Chiapas and the southern part of Chihuahua. |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
||
Micronesia, Federated States of |
No malaria transmission. |
n/a |
None. |
Moldova, Republic of |
No malaria transmission. |
n/a |
None. |
Monaco |
No malaria transmission. |
n/a |
None. |
Mongolia |
No malaria transmission. |
n/a |
None. |
Montenegro |
No malaria transmission. |
n/a |
None. |
Montserrat (UK) |
No malaria transmission. |
n/a |
None. |
Morocco |
No malaria transmission. |
n/a |
None. |
Mozambique |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Myanmar |
No transmission at elevations ≥ 1000 m or in urban areas. |
n/a |
None. |
Transmission occurs in areas at elevations < 1000 m, including Bagan, but not in urban areas. Human infection with P. knowlesi reported. |
P. vivax |
Atovaquone–proguanil, doxycycline or mefloquine. |
|
Mefloquine resistance has been reported in Kayin state and the eastern part of Shan state. For post-travel care, emerging artemisinin resistance is suspected in south-eastern Myanmar. P. vivax resistance to chloroquine has been reported. |
Atovaquone-proguanil or doxycycline. |
||
Namibia |
No transmission in the southern two-thirds of the country, including the city of Windhoek. |
n/a |
None. |
Transmission occurs in the regions of Kunene (including Etosha National park), Kavango (East and West), Ohangwena, Omaheke, Omusati, Oshana, Oshikoto, Otjozondjupa, and Zambezi. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Nauru |
No malaria transmission. |
n/a |
None. |
Nepal |
No transmission in Kathmandu, Pokhara, typical Himalayan treks, and all other areas not listed below. |
n/a |
None. |
Year-round transmission occurs at altitudes < 2000 m and in rural areas of the 20 Terai districts bordering India, with occasional seasonal outbreaks of P. f. Seasonal transmission of P. vivax takes place in 45 districts of the inner Terai and mid-hills. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Netherlands |
No malaria transmission. |
n/a |
None. |
New Caledonia (FR) |
No malaria transmission. |
n/a |
None. |
New Zealand |
No malaria transmission. |
n/a |
None. |
Nicaragua |
Little to no transmission in Boaco, Chinandega, Esteli, Jinotega, Leon, Matagalpa, Nueva Segovia, and Managua, and in departments not listed below. |
P. vivax |
PPM. |
Transmission occurs in Región Autónoma Atlántico Norte (RAAN), and Región Autónoma Atlántico Sur (RAAS). |
Atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
||
Niger |
All areas, except in the Sahara Desert. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Nigeria |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Niue (NZ) |
No malaria transmission. |
n/a |
None. |
Northern Mariana Islands (US) |
No malaria transmission. |
n/a |
None. |
Norway |
No malaria transmission. |
n/a |
None. |
Oman |
Sporadic transmission of P. f. and P. vivax may occur subsequent to imported cases. |
n/a |
None. |
Pakistan |
Transmission occurs in all areas, including urban areas < 2500 m. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
Palau |
No malaria transmission. |
n/a |
None. |
Panama |
Little to no transmission in Panama City, the Canal zone, or regions not listed below. |
P. vivax |
PPM. |
Low transmission in Ngäbe Buglé,Bocas del Toro, Chiriqui, Colon, and Veraguas on the west side of the canal. |
PPM. Travellers spending extended periods in this area may consider malaria chemoprophylaxis: atovaquone-proguanil, chloroquine, doxycycline or mefloquine. |
||
Most of the transmission occurs in provinces east of the Panama Canal towards the border with Colombia, where P. f. resistance to chloroquine has been reported. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Papua New Guinea |
All areas at elevations < 2000 m. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
Paraguay |
None. |
n/a |
None. |
Peru |
No transmission at elevations ≥ 2500 m, including the highland tourist areas (Machu Picchu, Lake Titicaca, and the urban areas of Arequipa, Cuzco, Puno), along the Pacific Coast of Lima Province. No transmission in the cities of Moquegua, Ica, Nazca, and Tacna. |
n/a |
None. |
All areas < 2500 m (except areas listed above). This includes the urban areas of Puerto Maldonado and Iquitos. Most P.f. cases occur in the region of Loreto. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Philippines |
No transmission in Manila and other urban areas. |
P. f. |
None. |
Transmission occurs in Palawan and Mindanao Islands. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Pitcairn Islands (UK) |
No malaria transmission. |
n/a |
None. |
Poland |
No malaria transmission. |
n/a |
None. |
Portugal |
No malaria transmission. |
n/a |
None. |
Puerto Rico (US) |
No malaria transmission. |
n/a |
None. |
Qatar |
No malaria transmission. |
n/a |
None. |
Réunion (FR) |
No malaria transmission. |
n/a |
None. |
Romania |
No malaria transmission. |
n/a |
None. |
Russian Federation (Russia) |
No malaria transmission. |
n/a |
None. |
Rwanda |
All areas. |
P.f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Saint-Barthélemy (FR) |
No malaria transmission. |
n/a |
None. |
Saint Helena (UK) |
No malaria transmission. |
n/a |
None. |
Saint Kitts and Nevis |
No malaria transmission. |
n/a |
None. |
Saint Lucia |
No malaria transmission. |
n/a |
None. |
Saint Martin (FR) |
No malaria transmission. |
n/a |
None. |
Saint Pierre and Miquelon (FR) |
No malaria transmission. |
n/a |
None. |
Saint Vincent and the Grenadines |
No malaria transmission. |
n/a |
None. |
Samoa |
No malaria transmission. |
n/a |
None. |
San Marino |
No malaria transmission. |
n/a |
None. |
São Tomé and Príncipe |
All areas. |
P.f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Saudi Arabia |
No transmission through most of the country. |
n/a |
None. |
Transmission occurs in Asir and Jazan emirates by the border with Yemen. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
Senegal |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Serbia |
No malaria transmission. |
n/a |
None. |
Seychelles |
No malaria transmission. |
n/a |
None. |
Sierra Leone |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Singapore |
No malaria transmission. |
n/a |
None. |
Saint Maarten (NL) |
No malaria transmission. |
n/a |
None. |
Slovakia |
No malaria transmission. |
n/a |
None. |
Slovenia |
No malaria transmission. |
n/a |
None. |
Solomon Islands |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Somalia |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
South Africa |
No transmission in most of the country, including the Garden Route and major urban areas. |
n/a |
None. |
Transmission occurs along the border with Zimbabwe and Mozambique. Specifically in Mopani, Vhembe, Greater Sekhukhune, Capricorn and Waterberg district municipalities of Limpopo Province; Ehlanzeni district municipality in Mpumalanga Province; and uMkhanyakude, Zululand and King Cetshwayo district municipalities in Kwazulu-Natal Province. Present in Kruger National Park. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|
South Sudan |
All areas, except in the Sahara Desert. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Spain |
No malaria transmission. |
n/a |
None. |
Sri Lanka |
No malaria transmission. |
n/a |
None. |
Sudan, Republic of |
All areas, except in the Sahara Desert. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Suriname |
Little to no transmission through most of the country. |
P. f. |
PPM. |
Transmission occurs in the Tapanahony municipality in Sipaliwini Province. For post-travel care, some decline in quinine sensitivity has been reported. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Swaziland (Eswatini) |
Little to no transmission through most of the country. |
P. f. |
PPM. |
Transmission occurs in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Sweden |
No malaria transmission. |
n/a |
None. |
Switzerland |
No malaria transmission. |
n/a |
None. |
Syrian Arab Republic (Syria) |
No malaria transmission. |
n/a |
None. |
Tajikistan |
Certified malaria-free in 2023. |
n/a |
None. |
Tanzania, United Republic of |
Transmission occurs in all areas at elevations < 1800 m, including Zanzibar. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Thailand |
Little to no transmission in other parts of the country not listed below, including the provinces of Chiang Mai and Chiang Rai, and the islands of Koh Pha Ngan, Koh Samui, and Phuket. |
n/a |
PPM. |
Transmission occurs in the provinces that border Myanmar, Cambodia, and Malaysia. Transmission also occurs in the Ubon Ratchathani and Phitsanulok Provinces (on the border with Laos), and the Surat Thani Province. There is resistance to mefloquine. For post-travel care, P. falciparum resistance to artemisinin has been reported near the border with Cambodia, and resistance to quinine near the borders with Cambodia and Myanmar. P. vivax resistance to chloroquine has been reported. |
P. vivax |
Atovaquone-proguanil or doxycycline. |
|
Timor-Leste (East Timor) |
Little to no transmission through much of country. |
P. f. |
PPM. |
Togo |
All areas. |
P. f |
Atovaquone-proguanil, doxycycline or mefloquine. |
Tokelau (NZ) |
No malaria transmission. |
n/a |
None. |
Tonga |
No malaria transmission. |
n/a |
None. |
Trinidad and Tobago |
No malaria transmission. |
n/a |
None. |
Tunisia |
No malaria transmission. |
n/a |
None. |
Türkiye |
No malaria transmission. |
n/a |
None. |
Turkmenistan |
No malaria transmission. |
n/a |
None. |
Turks and Caicos Islands (UK) |
No malaria transmission. |
n/a |
None. |
Tuvalu |
No malaria transmission. |
n/a |
None. |
Uganda |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Ukraine |
No malaria transmission. |
n/a |
None. |
United Arab Emirates |
No malaria transmission. |
n/a |
None. |
United Kingdom |
No malaria transmission. |
n/a |
None. |
United States |
No malaria transmission. |
n/a |
None. |
US Virgin Islands |
No malaria transmission. |
n/a |
None. |
Uruguay |
No malaria transmission. |
n/a |
None. |
Uzbekistan |
No malaria transmission. |
n/a |
None. |
Vanuatu |
All areas. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
Venezuela, Bolivarian Republic of |
Transmission occurs in all areas <1700 m. |
P. vivax |
Atovaquone-proguanil, doxycycline or mefloquine. |
Vietnam |
No transmission in Da Nang, Haiphong, Hanoi, Ho Chi Minh City (Saigon), NhaTrang, and Qui Nhon. |
n/a |
None. |
Little to no transmission in the Red River Delta and the Mekong Delta. The common coastal itinerary between Ho Chi Minh City and Hanoi with overnights mainly in urban areas does not typically require chemoprophylaxis. |
P. f. |
PPM. |
|
Transmission occurs in rural areas (except where there is resistance to mefloquine, see below). |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Transmission occurs in the rural areas of Dac Lac, Gia Lai, Khanh Hoa, Kon Tum, Lam Dong, Ninh Thuan, Song Be, and Tay Ninh. There is resistance to mefloquine. |
Atovaquone-proguanil or doxycycline. |
||
West Bank and Gaza Strip |
No malaria transmission. |
n/a |
None. |
Western Sahara |
Malaria transmission very rare. Unknown. |
Unknown |
PPM. |
Yemen |
No transmission at elevations > 2000 m, including in the city of Sana'a. |
n/a |
None. |
Little to no transmission on Socotra Island. |
P. f. |
PPM. |
|
Transmission occurs in all areas at elevations < 2000 m, except Socotra Island. |
Atovaquone-proguanil, doxycycline or mefloquine. |
||
Zambia |
All areas. |
P. f. |
Atovaquone-proguanil, doxycycline or mefloquine. |
Zimbabwe |
Low transmission in Harare and Bulawayo, and areas ≥ 1200 m. |
P. f. |
PPM. |
Atovaquone-proguanil, doxycycline or mefloquine. |
|||
Transmission occurs in all areas at elevations < 1200 m. |
|||
Abbreviations: FR, France; n/a, not applicable; NL, Netherlands; NZ, New Zealand; PPM, personal protective measures; UK, United Kingdom; US, United States. *Additional plasmodium species (i.e., P. ovale and P. malariae) may be present. |
|||
References
- World Health Organization. (2023). World malaria report 2023. World Health Organization. https://www.who.int/publications/i/item/9789240086173.
- Malaria Information and Prophylaxis, by Country. Centers for Disease Control and Prevention. CDC Yellow Book 2024: Health Information for International Travel. https://www.cdc.gov/malaria/travelers/country_table/a.htm
- World Health Organization. International travel and health. Vaccination requirements and recommendations for international travellers; and malaria situation per country – 2022 edition
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