Low Risk Malaria Areas
Precautions against mosquito bites and malaria are necessary in all countries where malaria transmission is known to occur, regardless of the estimated level of risk.
Anti malaria tablets are essential in countries where there is high or variable risk of malaria, but may not be advised in low risk malaria areas. Even in low risk areas, you must always protect against mosquito bites by covering your skin with clothing, using insect repellent and sleeping under a mosquito net when necessary.
Maximum concentration Deet insect repellent for severe conditions. Repels insects for 5 to 6 hours. Ideal for when reapplication is awkward. Only for short term use.
If you are visiting a low risk malaria area, never assume other parts of the same country or bordering countries are also low risk. Many countries have both low and high-risk malaria areas, which may be of significance if you are travelling around.
Africa
Although the risk of malaria in most African countries is high, there are some low risk malaria areas, including:
- Algeria – south and south eastern areas
- Botswana – southern areas
- Cape Verde – a small number of malaria cases have been reported on Sao Tiago Island and Boavista Island
- Eritrea – Asmara
- Ethiopia – Addis Ababa
- Kenya – Nairobi and the highlands
- Mauritania – far northern areas
- Namibia – southern areas
- South Africa – most of the country
- Swaziland – western areas
- Zimbabwe – areas around Harare and Bulawayo
Malaria free countries in Africa include Egypt, Lesotho, Libya, Mauritius, Morocco, Reunion, Saint Helena, Seychelles, Tunisia and Western Sahara.
Central America
There are low and variable risk malaria areas throughout Central America, including:
- Belize – low and variable risk areas throughout
- Costa Rica – low risk throughout, apart from Limon province, which is classified as variable risk
- El Salvador – entire country is low risk
- Guatemala – variable risk in areas below 1,500m. Guatemala city, Antigua and Lake Atitlan are low risk areas
- Honduras – variable malaria risk throughout
- Nicaragua – variable risk of malaria in most of the country, apart from some southern regions where the risk is low
- Panama – low or variable risk everywhere apart from eastern provinces
North America
Mexico is the only part of North America where malaria occurs. While there is low to no risk throughout most of the country, there is variable risk in non-tourist, rural areas of Chiapas and Oaxaca.
There is no malaria in Alaska, Bermuda, Canada, Greenland, Hawaii, Maui, Oahu, Saint Pierre and Miquelon or the United States of America.
South America
With the exception of Chile, the Falkland Islands and Uruguay, all countries in South America have low, variable or high-risk malarial areas. Low risk malaria areas in South America include:
- Argentina – low risk throughout, with variable risk along borders with Bolivia and Paraguay
- Bolivia – areas above 2,500m, with some variable risk regions
- Brazil – areas outside Amazonia, including southwards along the east coast, Sao Paulo, Rio de Janeiro and Iguacu Falls
- Colombia – variable risk in areas above 1,700m, low risk in Bogota and Cartagena
- Ecuador – Guayaquil, Quito and the Galapagos Islands
- French Guiana – Cayenne and Devils Island
- Guyana – coastal areas
- Paraguay – mostly low risk, except for variable risk in Alto Parana and Caaguazu
- Peru – variable or low risk everywhere apart from north eastern areas
- Suriname – coastal areas, including Paramaribo
- Venezuela – variable or low risk areas north of the Orinoco river
Central Asia
The risk of malaria is low in Afghanistan at altitudes above 2,000m, and in the far northern Himalayas of Pakistan. There is a very small risk of malaria in areas of Kyrgyzstan that border other countries with malaria. Tajikistan has mostly low risk areas with variable risk in others. Malaria rarely occurs in Uzbekistan.
There is no malaria in Kazakhstan or Turkmenistan.
East Asia
Most East Asian countries have high-risk malaria areas as well as low risk regions. Low risk areas include:
- Bangladesh – most of the country
- Bhutan – everywhere except southern districts
- Cambodia – areas around Tonle Sap Lake and the capital city Phnom Penh
- China – everywhere except Hainan Island and Yunnan Province
- India – low or variable risk everywhere except Assam. No malaria in some high altitude areas
- Indonesia – many areas of Bali and Java
- Democratic People's Republic of Korea (North Korea) – everywhere
- Republic of Korea (South Korea) – everywhere
- Malaysia – some areas in both east and west Malaysia
- Myanmar (formerly Burma) – areas above 1,000m, Mandalay and Yangon
- Nepal – Kathmandu
- Philippines – areas above 600m and urban areas
- Sri Lanka – everywhere apart from north and north eastern areas, which are variable risk
- Thailand – everywhere except along some international borders and forested areas
- Vietnam – Hanoi, Red River delta, the north coast of Nha Trang and Ho Chi Minh City
There is no malaria in Brunei Darussalam, Hong Kong, Japan, Macao, Maldives, Mongolia or Singapore.
Caribbean
Most countries in the Caribbean are malaria free, apart from Haiti and the Dominican Republic, where there is high or variable risk of malaria.
There is no malaria in Anguilla, Antigua and Barbuda, Netherlands Antilles, Bahamas, Barbados, British Virgin Islands, Cayman Islands, Cuba, Dominica, Grenada, Guadeloupe, Jamaica, Martinique, Monserrat, Puerto Rico, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Trinidad and Tobago, Turks and Caicos or the US Virgin Islands.
Europe
Most of Europe is malaria free, with the exception of Armenia, Azerbaijan, Georgia, Greece and Turkey, where there is low risk of malaria transmission.
- Armenia – low risk throughout, but malaria precautions are necessary in some parts of the Ararat Valley
- Azerbaijan – variable risk in rural areas below 1,500m, between the Kura and Arax rivers, low risk elsewhere
- Georgia – there is a risk of malaria transmission in the south east near the Azerbaijan border
- Greece – rare cases reported in Lakonia and some other non-tourist areas
- Turkey – variable risk in the south east
There is no malaria in Albania, Austria, Belarus, Belgium, Bosnia Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Faroe Islands, Finland, France, Germany, Gibraltar, Hungary, Iceland, Republic of Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Portugal, Republic of Macedonia, Malta, Republic of Moldova, Monaco, Montenegro, Netherlands, Norway, Poland, Romania, Russian Federation, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland or the Ukraine.
Middle East
Some countries in the Middle East have low risk malaria areas, including:
- Iran – low risk throughout apart from some southern areas
- Iraq – low risk throughout country; malaria cases have been reported in some provinces below 1,500m
- Oman – malaria is uncommon; cases have occurred due to importation from other countries
- Saudi Arabia – low to no risk in most of the country, apart from some southwestern areas. Jeddah, Mecca, Medina and Taif are low risk
- Yemen – low risk in Sana'a and at altitudes above 2,000m
There is no malaria in Abu Dhabi, Bahrain, Dubai, Israel, Jordan, Kuwait, Lebanon, Qatar, Syria or the United Arab Emirates.
Oceania
Most of Oceania is malaria free, apart from Vanuatu, the Solomon Islands and Papua New Guinea, where there is a high risk of malaria.
There is no malaria in American Samoa, Australia, Christmas Island, Cook Islands, Federated States of Micronesia, Fiji, French Polynesia, Guam, Kiribati, Marshall Islands, Nauru, New Caledonia, New Zealand, Niue, Northern Mariana Islands, Palau, Pitcairn, Samoa, Tasmania, Tokelau, Tonga or Tuvalu.
References:
- Centers for Disease Control and Prevention: Malaria
- Fit For Travel: Destinations
