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Malaria Information and Prophylaxis, by Country [S]

The information presented in this table is consistent 1 with the information in the CDC Health Information for International Travel (the “Yellow Book,” New for 2018).
Click on the linked country name for a malaria map of that country.

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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
Saint Helena (U.K.) None None Not Applicable Not Applicable Not Applicable
Saint Kitts (Saint Christopher) and Nevis (U.K.) None None Not Applicable Not Applicable Not Applicable
Saint Lucia None None Not Applicable Not Applicable Not Applicable
Saint Pierre and Miquelon (France) None None Not Applicable Not Applicable Not Applicable
Saint Vincent and the Grenadines None None Not Applicable Not Applicable Not Applicable
Samoa (formerly Western Samoa) None None Not Applicable Not Applicable Not Applicable
San Marino None None Not Applicable Not Applicable Not Applicable
São Tomé and Príncipe All Very Low Chloroquine P. falciparum 85%,
P. malariae, P. ovale, and P. vivax 15% combined		 Atovaquone-proguanil, doxycycline, or mefloquine
Saudi Arabia Rare cases in Asir and Jazan emirates by border with Yemen. None in the cities of Jeddah, Mecca, Medina, Riyadh, and Ta’if. Very Low Chloroquine P. falciparum predominantly
Remainder P. vivax 		Mosquito avoidance only 1) City(ies) of travel
2) Emirate(s) of travelTo determine if a city is within a certain emirateMap of regions of Saudi Arabia
Senegal All High Chloroquine P. falciparum >85%
P. ovale 5-10%
P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Serbia None None Not Applicable Not Applicable Not Applicable
Seychelles None None Not Applicable Not Applicable Not Applicable
Sierra Leone All High Chloroquine P. falciparum >85%
P. ovale 5%-10%,
P. malariae and P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Singapore None None Not Applicable Not Applicable Not Applicable
Slovakia None None Not Applicable Not Applicable Not Applicable
Slovenia None None Not Applicable Not Applicable Not Applicable
Solomon Islands All High Chloroquine P. falciparum 60%
P. vivax 35-40%
P. ovale <1%		 Atovaquone-proguanil, doxycycline, or mefloquine
Somalia All High Chloroquine P. falciparum 90%
P. vivax 5%-10%
P. malariae, and P. ovale rare		 Atovaquone-proguanil, doxycycline, or mefloquine
South Africa Present along the border with Zimbabwe and Mozambique. Specifically in Vhembe and Mopani district municipalities of Limpopo Province; Ehlanzeni district municipality in Mpumalanga Province; and Umknanyakude in Kwazulu-Natal Province. Present in Kruger National Park. Outbreak in two areas of Gauteng Province late September to early October 2017. Low Chloroquine P. falciparum 90%
P. vivax 5%
P. ovale 5%		 Areas in Limpopo, Mpumalanga, and Kwazulu-Natal Province with malaria:
Atovaquone-proguanil, doxycycline, or mefloquine
Gauteng Province: Mosquito avoidance only		 Province(s) of travel

Provinces of South Africa to determine if a city is within a certain province
South Georgia and the South Sandwich Islands None None Not Applicable Not Applicable Not Applicable
South Korea Limited to the months of March–December in rural areas in the northern parts of Incheon, Kangwon-do, Kyonggi-do Provinces including the demilitarized zone (DMZ). Low None P. vivax 100% Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7

 
Provinces(s) of travelAdministrative divisions of South Korea
South Sudan, Republic of All High Chloroquine P. falciparum 90%,
P.vivax 5%–10%,
P. malariae and P. ovale rare.		 Atovaquone-proguanil, doxycycline, or mefloquine
Spain None None Not Applicable Not Applicable Not Applicable
Sri Lanka None None Not applicable Not applicable Not applicable
Sudan All High Chloroquine P. falciparum 90%,
P.vivax 5%–10%,
P. malariae and P. ovale rare.		 Atovaquone-proguanil, doxycycline, or mefloquine
Suriname Present in the municipality of Tapanahony in Sipaliwini Province. Rare cases Brokopondo Province, and Boven Saramacca municipality in Sipaliwini Province. No malaria in Paramaribo. Low Chloroquine P. falciparum 70%
P. vivax 15-20%		 Tapanahony municipality in Sipaliwini Province: Atovaquone-proguanil, doxycycline, or mefloquine
Other areas with malaria: Mosquito avoidance only		 Province(s) of travel

Map provinces of Suriname to determine if a city is within a certain province
Swaziland Present in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts. Very Low Chloroquine P. falciparum 99%
P. ovale and P. vivax 1%		 Atovaquone-proguanil, doxycycline, or mefloquine District(s) of travel

Districts of Swaziland to determine if a city is within a certain district
Sweden None None Not Applicable Not Applicable Not Applicable
Switzerland None None Not Applicable Not Applicable Not Applicable
Syria None None Not Applicable Not Applicable Not Applicable

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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