Malaria Information and Prophylaxis, by Country [P]

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The information presented in this table is consistent 1 with the information in the CDC Health Information for International Travel (the “Yellow Book”).

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Malaria Information and Prophylaxis by Country
Country Areas with Malaria Drug Resistance2 Malaria Species3 Recommended Chemoprophylaxis4 Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
Pakistan All areas (including all cities) at altitudes < 2,500 m (8,202 ft) Chloroquine P. vivax 80%,

P. falciparum 20%

 Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine5 Altitude of city(ies) of travel

Altitude information
Palau None Not Applicable Not Applicable Not Applicable
Panama Present in the provinces of Bocas del Toro, Chiriqui, Colon, Darien (including Emberá), Kuna Yala (also spelled Guna Yala), Ngäbe-Buglé, eastern Panama province, and Verugas. None in Panama Oeste, the Canal Zone, and Panama City. Chloroquine (east of the Panama Canal) P. vivax 97%,

P. falciparum 3%

 Provinces of Darien (including Emberá), Guna Yala, and eastern Panama province: Atovaquone-proguanil, doxycycline, mefloquine, primaquine5, or tafenoquine5. Bocas del Toro, Chiriqui, Colon, Ngäbe-Buglé, and Veraguas: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,5 or tafenoquine.5 City(ies) of travel

Map of Provinces in Panama to determine if a city is within a certain province
Papua New Guinea Present throughout country at altitudes < 2,000 m (6,562 ft) Chloroquine (both P. falciparum and P. vivax) P. falciparum 75%,
P. vivax 25%;P. malariae and P. ovale rare		 Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine5 Altitude of city(ies) of travel

Altitude information
Paraguay None Not applicable Not applicable Not applicable
Peru All departments < 2,500 m (8,202 ft), including the cities of Iquitos and Puerto Maldonado, and only the remote eastern regions of La Libertad and Lambayeque. None in the following areas: Lima Province; the cities of Arequipa, Ica, Moquegua, Nazca, Puno, and Tacna; the highland tourist areas (Cuzco, Machu Picchu, and Lake Titicaca); and along the Pacific Coast. Chloroquine P. vivax 80%,

P. falciparum 20%

 Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine5 1) City(ies) of travel
2) Province(s) of travel
3) Altitude of city(ies) of travel
Altitude information and to determine if a city is within a certain province.
Map of provinces of Peru
Philippines Present in Palawan and Mindanao Islands. None in metropolitan Manila and other urban areas. Chloroquine P. falciparum 85%;
P. vivax 15%;
P. knowlesi,7 P. malariae, and P. ovale  rare		 Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine5 1) City(ies) of travel
2) Island(s) of travel
3) Altitude of city(ies) of travel
Altitude information and to determine if a city is within a certain Island.Map of Administrative divisions of the Philippines.
Pitcairn Islands (U.K.) None Not Applicable Not Applicable Not Applicable
Poland None Not Applicable Not Applicable Not Applicable
Portugal None Not Applicable Not Applicable Not Applicable
Puerto Rico (U.S.) 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.  Refers to P. falciparum malaria unless otherwise noted.
3. Estimates of malaria species are based on best available data from multiple sources. Where proportions are not available, the primary species and less common species are identified.
4. 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.
5. Primaquine and tafenoquine can cause hemolytic anemia in persons with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Before prescribing primaquine or tafenoquine, patients must be screened for G6PD deficiency using a quantitative test.
6. Mosquito avoidance includes applying topical mosquito repellant, sleeping under an insecticide treated bed net, and wearing protective clothing (e.g., long pants and socks, long sleeve shirt). For additional details on mosquito avoidance, see: https://www.cdc.gov/malaria/travelers/index.html
7. P. knowlesi is a malaria species with a simian host (macaque). Human cases have been reported from most countries in Southeast Asia and are associated with activities in forest or forest-fringe areas. This species of malaria has no known resistance to antimalarials.