While you want to prevent malaria when travelling, different antimalarial medications are designed for different strains of malaria. So the recommended malaria tablets can vary from country to country. Here’s a general guide to help you decide which medication is best.
These antimalarials are ideal for long trips since you don't have to take it very often. You only take them once a week, and they are suitable for use during all pregnancy trimesters. On the other hand, they're not ideal for shorter or last-minute trips, since you have to start taking them 1-2 weeks before your trip and for four weeks after returning. As Chloroquine and Mefloquine has a longer course than other antimalarials, it can be very inconvenient if you suffer from any side effects. Chloroquine is also not suitable for those who have psoriasis, as it can exacerbate the condition.
This drug is ideal for short trips or last-minute travel decisions. You can start taking it a day or two ahead of your travel, and you will only need to continue taking it for seven days after you return from your trip. This antimalarial has very few side effects, and those that it produces are quite rare. It is also available in a paediatric form for children. The downsides to atovaquone are that it cannot be taken by very young children or by women who are pregnant or breastfeeding. It also needs to be taken daily, and it tends to be quite expensive.
Doxycycline can be taken a day or two from the travel date and is much less expensive than most antimalarials. It must be taken daily, and it has been found to cause side effects such as yeast infections, an upset stomach and sun sensitivity. It is also not appropriate for children under eight years old or for women who are pregnant or breastfeeding.
The lists below outline which malaria medication is suitable for which country. It is still a good idea to check with your doctor which antimalarial will be best for you. The regions you intend to travel to, the time of year and any personal health conditions may have an influence over which medication is best recommended for you.
Atovaquone-Proguanil, Doxycycline: Burma, Cambodia, China, Laos, Thailand, Vietnam.
Atovaquone-Proguanil, Doxycycline, Mefloquine: Afghanistan, Angola, Bangladesh, Benin, Botswana, Brazil, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Chad, Colombia, Comoros, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Djibouti, Ecuador, Equatorial Guinea, Eritrea, Ethiopia, French Guiana, Gabon, Gambia, Ghana, Guatemala, Guinea, Guinea-Bissau, Guyana, India, Indonesia, Iran, Kenya, Liberia, Madagascar, Malawi, Malaysia, Mali, Mauritania, Mozambique, Namibia, Nepal, Niger, Nigeria, Pakistan, Papua New Guinea, Peru, Philippines, Rwanda, São Tomé and Príncipe, Senegal, Sierra Leone, Solomon Islands, Somalia, South Africa, South Sudan, Sudan, Suriname, Swaziland, Tanzania, Timor-Leste, Togo, Uganda, Vanuatu, Venezuela, Yemen, Zambia, Zimbabwe.
Atovaquone-Proguanil, Doxycycline, Mefloquine, Primaquine: Bolivia, Burundi, Mexico, Panama.
Atovaquone-Proguanil, Doxycycline, Mefloquine, Chloroquine: Dominican Republic, Haiti, Nicaragua.
Atovaquone-Proguanil, Doxycycline, Mefloquine, Primaquine, Chloroquine: Cyprus (North only), Honduras, North Korea, South Korea.
Mosquito Avoidance Only: Belize, Bhutan, Costa Rica, El Salvador, Italy (Ginosa only), Mayotte, Oman, Saudi Arabia, Tajikistan, Western Sahara.