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Malaria Information and Prophylaxis, by Country
CountryAreas with MalariaEstimated relative risk of Malaria for US Travelers2Drug Resistance3Malaria Species4Recommended Chemoprophlaxis5Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
CambodiaPresent throughout the country including Siem Reap city.
Rare cases in Phnom Penh. None at the temple complex at Angkor Wat, and around Lake Tonle Sap
P. falciparum 86%
P. vivax 12%
P. malariae 2%
In the provinces of Banteay Meanchey, Battambang, Kampot, Koh Kong, Odder Meanchey, Pailin, Preah Vihear, Pursat, and Siem Reap bordering Thailand: Atovaquone-proguanil or doxycycline
All other areas with malaria: Atovaquone-proguanil, doxycycline, or mefloquine
Phnom Penh: mosquito avoidance only
CameroonAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
CanadaNoneNoneNot ApplicableNot ApplicableNot Applicable
Canary Islands (Spain)NoneNoneNot ApplicableNot ApplicableNot Applicable
Cape VerdeLimited cases in Sao Tiago Island.Very LowChloroquinePrimarilyP. falciparumMosquito avoidance only
Cayman Islands (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
Central African RepublicAllHighChloroquineP. falciparum 85%
P. malariaeP. ovale, and P. vivax 15% combined
Atovaquone-proguanil, doxycycline, or mefloquine
ChadAllHighChloroquineP. falciparum 85%
P. malariaeP. ovale, and P. vivax 15% combined
Atovaquone-proguanil, doxycycline, or mefloquine
ChileNoneNoneNot ApplicableNot ApplicableNot Applicable
ChinaPresent year round in rural parts of Anhui, Guizhou, Hainan, Henan, Hubei, and Yunnan Provinces.
Rare cases occur in other rural parts of the county below 1,500 m (4,921 ft) May–December. None in urban areas.
Some major river cruises may go through malaria endemic areas in Anhui and Hubei Provinces.
Primarily P. vivax
P. falciparum in select locations
Along China-Burma (Myanmar) border in the western part of Yunnan province: Atovaquone-proguanil or doxycycline

Hainan and other parts of Yunnan province: Atovaquone-proguanil, doxycycline, or mefloquine

Anhui, Guizhou, Henan, and Hubei provinces: Atovaquone-proguanil, chloroquine, doxycyline, mefloquine, or primaquine7

All other areas with malaria including river cruises that pass through malaria-endemic provinces: Mosquito avoidance only.
Christmas Island (Australia)NoneNoneNot ApplicableNot ApplicableNot Applicable
Cocos (Keeling) Islands (Australia)NoneNoneNot ApplicableNot ApplicableNot Applicable
ColombiaAll areas below 1,700 m (5,577 ft). None in Bogota and CartagenaLowChloroquineP. falciparum 35–40%
P. vivax 60–65%
Atovaquone-proguanil, doxycycline, or mefloquine
ComorosAllNo dataChloroquinePrimarily P. falciparumAtovaquone-proguanil, doxycycline, or mefloquine
Congo, Republic of the (Congo-Brazzaville)AllHighChloroquineP. falciparum 90%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Cook Islands (New Zealand)NoneNoneNot ApplicableNot ApplicableNot Applicable
Costa RicaNoneNoneNot applicableNot applicableNot applicable
Côte d'IvoireAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
CroatiaNoneNoneNot ApplicableNot ApplicableNot Applicable
CubaNoneNoneNot ApplicableNot ApplicableNot Applicable
CyprusNoneNoneNot ApplicableNot ApplicableNot Applicable
Czech RepublicNoneNoneNot ApplicableNot ApplicableNot Applicable
Congo, Democratic Republic of the (Congo-Kinshasa)AllModerateChloroquineP. falciparum 90%
P. ovale 5%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
  1. The information presented herein was accurate at the time of publication; however, factors that can change rapidly and from year to year, such as local weather conditions, mosquito vector density, and prevalence of infection, can markedly affect local malaria transmission patterns.

  2. This estimate of risk is based on numbers of cases of malaria reported in US travelers and the estimated volume of travel to these countries. In some instances the risk may be low because the actual intensity of transmission is low in that country. In other instances, significant malaria transmission may occur only in small focal areas of the country where US travelers seldom go. Thus even though the risk for the average traveler to that country may be low, the risk for the rare traveler going to the areas with higher transmission intensity will of course be higher. For some countries that are rarely visited by US travelers, there is insufficient information to make a risk estimate.

  3. Refers to P. falciparum malaria unless otherwise noted.

  4. Estimates of malaria species are based on best available data from multiple sources.

  5. Several medications are available for chemoprophylaxis. When deciding which drug to use, consider specific itinerary, length of trip, cost of drug, previous adverse reactions to antimalarials, drug allergies, and current medical history. All travelers should seek medical attention in the event of fever during or after return from travel to areas with malaria.

  6. This risk estimate is based largely on cases occurring in US military personnel who travel for extended periods of time with unique itineraries that likely do not reflect the risk for the average US traveler.

  7. Primaquine can cause hemolytic anemia in persons with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Patients must be screened for G6PD deficiency prior to starting primaquine.

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