Malaria Information and Prophylaxis, by Country [I]
Country | Areas with Malaria | Estimated relative risk of Malaria for US Travelers2 | Drug Resistance3 | Malaria Species4 | Recommended Chemoprophylaxis5 | Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries |
---|---|---|---|---|---|---|
Iceland | None | None | Not Applicable | Not Applicable | Not Applicable | |
India | All areas throughout country including cities of Bombay (Mumbai) and Delhi, except none in areas above 2,000 m (6,562 ft) in Himachal Pradesh, Jammu and Kashmir, and Sikkim. | Moderate | Chloroquine |
P. vivax 50% P. falciparum >40% P. malariae and P. ovale rare |
Atovaquone-proguanil, doxycycline, or mefloquine | 1) City(ies) of travel 2) Altitude of city(ies) of travel 3) Province(s) of travelAltitude information and to determine if city is within a certain provinceMap of provinces in India |
Indonesia | All areas of eastern Indonesia (provinces of Maluku, Maluku Utara, Nusa Tenggara Timur, Papua, and Papua Barat) including town of Labuan Bajo and Komodo Islands in the Nusa Tengarra region. Rural areas of Kalimantan (Borneo), Nusa Tenggara Barat (includes the island of Lombok), Sulawesi, and Sumatra.
Low transmission in rural areas of Java including Pangandaran, Sukalumi, and Ujung Kulong. None in the cities of Jakarta, and Ubud, or resort areas of Bali and Java, and Gili Islands, and the Thousand Islands (Pulau Seribu). |
Low | Chloroquine (P. falciparum and P. vivax) |
P. falciparum 57%, P. vivax 43%, P. knowlesi, P. malariae, ovale rare |
Atovaquone-proguanil, doxycycline, or mefloquine | 1) City(ies) of travel 2) Province(s) of travel 3) Island(s) of travelMap of provinces of IndonesiaTo determine if a city is within a certain province |
Iran | Rural areas of Fars Province, Sistan-Baluchestan Province, and southern, tropical parts of Hormozgan and Kerman Provinces. | Very low | Chloroquine |
P. vivax 93% P. falciparum 7% |
Atovaquone-proguanil, doxycycline, or mefloquine | Province(s) of travel |
Iraq | None | None | Not Applicable | Not Applicable | Not Applicable | |
Ireland | None | None | Not Applicable | Not Applicable | Not Applicable | |
Israel | None | None | Not Applicable | Not Applicable | Not Applicable | |
Italy including Holy See (Vatican City) | Four cases of P. falciparum malaria reported in agricultural workers in Ginosa, Taranto Province, in the Apulia Region. | None | Not Applicable | Not Applicable | For agricultural areas of Ginosa: mosquito avoidance |
1. Factors that affect local malaria transmission patterns can change rapidly and from year to year, such as local weather conditions, mosquito vector density, and prevalence of infection. Information in these tables is updated regularly.
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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- Page last reviewed: October 10, 2017
- Page last updated: October 10, 2017
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