There is no malaria risk and no preventive measures are necessary in ALGERIA (there was an extremely small malaria risk due to Plasmodium vivax, especially in the 6 southern and south-eastern regions; Adrar, El Oued, Ghardaia, Illizi, Ouargla and Tamanrasset; there may still be an exceptional risk of local contagion of Plasmodium falciparum in the extreme south of the country), or in MOROCCO. There is no risk in LIBYA, TUNISIA and the WESTERN SAHARA. In EGYPT there is no longer a risk except for an extremely limited risk from June to October in the Sennoris district of the El Faiyûm region (no cases have been reported since 1998). The standard precautions against mosquito bites in the evening and at night are sufficient for those spending the night in primitive conditions in Algeria and Egypt.
[http://www.mara.org.za --> maps --> information on maps].
1. WEST AFRICA AND CONGO (KINSHASA)
Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Congo-Brazzaville, Congo-Kinshasa (ex-Zaire), Gabon, Gambia, Ghana, (Equatorial) Guinea, Guinea Bissau, Guinea (Conakry), Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Sao Tome and Principe, Senegal, Sierra Leone, Togo.
There is a serious malaria risk (unless otherwise stated).
For protective measures see NOTE 1.
Mauritania (*): There is no malaria risk in the Northern provinces: Dakhlet-Nouadhibou and Tiris-Zemour. There is a major risk in the southern provinces below the latitude of 22 degrees north (and thus also in the capital Nouackchott). In the provinces of Adrar and Inchiri (between the northern and southern provinces) there is a risk of malaria during the rainy season (from July to October). NOTE 1 is applicable.
Burundi, Comores, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mayotte (FR), Mozambique, Uganda, Rwanda, Sudan, Somalia, Tanzania (and Zanzibar and Pemba), Zambia, Zimbabwe.
There is a serious malaria risk (unless otherwise stated).
For protective measures see NOTE 1.
Eritrea, Ethiopia (*): No risk above 2000 m, hence no risk in the capital cities.
Kenya (*): There is little to no risk in Nairobi. There is a substantial risk in all areas below 1500 m. Above 1500 m the risk is low (but with strong variations and certainly not completely absent). There is no risk in the high areas (above 2500 m) in the following provinces: Central, Rift Valley, Eastern, Nyanza and Western Provinces. Most travellers will, however, pass through a number of regions and will therefore have to take precautions to protect themselves against malaria.
Malawi (*): Although there is a risk throughout the whole year and in the entire country (according to the World Health Organization (WHO)), it is highest from November to April in the areas below 500-1000 m along Lake Malawi.
Sudan (*): There is a high risk of malaria in the central and southern part of the country. The risk is low and seasonal in the Northern part of the country. It is higher along the Nile, south of Lake Nasser. It is very limited on the coast (Red Sea).
Somalia: There is risk of malaria the whole year through in the entire country; in the northern part of the country, the risk is low and seasonal; the risk is higher in the central and southern part of the country.
Tanzania (*): Malaria risk only below 1800 m. Most travellers will, however, pass through several regions and will have to take protective measures against malaria. There is risk of malaria on the islands of Zanzibar and Pemba, but to a lesser extent (the situation may easily get worse).
Zimbabwe (*): There is a risk of malaria throughout the whole year in the areas below 600 m (including the Zambezi valley and Victoria Falls). There is a risk of malaria from November to June in the areas up to 600-1200 m high. There is little or no risk in the cities of Harare and Bulawayo, or on the plateau between these two towns. Most travellers will, however, pass through a number of regions and should therefore take tablets to protect themselves against malaria.
Botswana (*): Risk of malaria from November to May/June in the Northern border provinces, north of the 21° south latitude, (especially in the districts/subdistricts: Boteti, Chobe, Ngamiland, Okavango and Tutume). No risk of malaria in other areas. NOTE 1 is applicable.
Protective measures against mosquito bites in the evenings and at night are certainly adequate from June to October. In case of fever, malaria should always be considered!
Lesotho: No malaria risk.
Namibia (*): There is some risk of malaria in the northern part of the country:
(1) the whole year in a 100-150 km strip along the border with Angola; in the Caprivi province, the Okavango province (the region south of the Kavango river) and the Kunene province (along the Kunene river); NOTE 1 is applicable.
(2) from November to May/June in the other Northern Provinces Oshana, Oshikoto, Omusati and Ohangwena and the more central provinces Omaheke and Otjozondjupa. There is a malaria risk in the Etosha National Park from November to May/June. NOTE 1 is applicable.
Protective measures against mosquito bites in the evenings and at night are certainly adequate from June to October. In case of fever, malaria should always be considered.
Swaziland (*): There is a risk of malaria only in the low-lying areas of the Eastern half of the country, especially in Big Bend, Mhlme, Simunye and Tshaneni.
South Africa (*): No risk in most of the country. There is a risk of malaria - during the whole year - especially during the Summer months from October to May and some cases are reported in the winter, in the dry savanna areas (away from the big towns) in the extreme north and north-east of the country along the border with Botswana, Zimbabwe and Mozambique: this is in the low-lying regions in the Northern Province (Limpopo), in the north-eastern part of the Mpumalanga province (known as Transvaal) and including Krüger National Park and the north-eastern part of KwaZulu/Natal (as far as the Tugela River south of the town of Richard’s Bay). NOTE 1 applies from October to May.
Protective measures against mosquito bites in the evenings and at night are certainly adequate from June to September. In case of fever, malaria should always be considered.
See map for details: http://www.malaria.org.za/Malaria_Risk/Risk_Maps/risk_maps.htm.
Azores & Madeira (Portugal), Canary Islands (Spain), Reunion (FR), Seychelles, Saint Helena (UK), Mauritius and most of the Cape Verde Islands.
There is a very low risk from August to November on Sao Tiago Island (from the Cape Verde Islands). If the night is spent here in primitive conditions, precautions against mosquitoes in the evenings and at night are sufficient (in case of fever, malaria should always be considered); no chemoprophylaxis is recommended by WHO.
To be optimally protected against malaria, it is essential to take protective measures against mosquito bites in the evening and at night. In case of an overnight stay in primitive conditions travellers should impregnate their mosquito net with permethrine or deltamethrine, a chemical substance that provides an extra mosquito-repellent and mosquitocidal effect.
(*) General precautions for visiting regions without
malaria risk:
People who visit malaria regions during the day and spend their nights
in good hotels are not at risk, and do not need to take any antimalaria
tablets. They should however always carry a mosquito repellent product with
them for application to the skin, in case they cannot return to the hotel on
time in the evening, for example because of unforeseen problems such as
illness, car breakdown, etc. The mosquito repellent should also be
generously applied to the skin when on a trip or a safari in the early
morning, in the evening or at night.
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NOTE 1 |
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MALARONE®
(1 tablet daily starting from the day before departure to 7 days after return or after leaving risk area)
OR
DOXYCYCLINE (1 tablet daily starting from the day before departure to
4 weeks after return; sometimes it may be necessary to test the tolerance of
this medication during a few days) OR
LARIAM® (1 tablet / week starting 2-3 weeks before
departure to 4 weeks after return) are the first choice of antimalaria drugs.
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DIARRHOEA is a frequent problem when travelling. Even when travelling in good conditions, it is not always possible to avoid it. Some advice and the correct medication from a travel pharmacy are very useful. Please consult the general text on traveller’s diarrhoea where the precautions and correct treatment are described.
| DENGUE In Africa dengue fever may occur. Prevention = apply protective measures against mosquito bites during the day. Consult the text on dengue: http://www.travelhealth.be & consult the world card on http://www.who.int/ith ® "disease distribution maps". |
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• YELLOW FEVER vaccination is required for all countries where yellow fever can occur (http://www.who.int/ith/en/index.html ® disease distribution maps). Not all these countries always require this vaccination, but its application – in addition to the protection it offers – is useful to avoid problems at border crossings or when in transit through another country.
Vaccination is therefore required for: Angola, Benin, Burkina Faso, Burundi, Central African Republic, Cameroon, Chad (*), Congo-Brazzaville, Congo-Kinshasa, Ethiopia, Gabon, Gambia, Ghana, Equatorial Guinea, Guinea (Conakry), Guinea Bissau, Ivory Coast, Kenya (low risk in the cities of Nairobi and Mombasa; from the age of 9 months), Liberia, Mali (*), Mauritania (*), Niger (*), Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan (a certificate is officially required for travellers (> 9 months) coming from a yellow fever endemic region and may be officially required when leaving Sudan), Tanzania, Zanzibar,Togo, Uganda.
(*) for all travellers from the age of 9 months travelling to the southern region of the Sahara desert.
A number of countries where yellow fever does not occur only require a yellow fever vaccination if travelling from or through one of the above-mentioned countries (thus not if travelling from Belgium):
Algeria, Botswana, Cape Verde, Djibouti, Egypt (airline passengers in transit coming from a yellow fever endemic region who are not in possession of a vaccination certificate may not leave the airport), Lesotho, Libya, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Reunion, Seychelles, Saint Helena, Swaziland, Zambia, Zimbabwe, South Africa.
• Travelling to Africa is also a good opportunity to get your TETANUS-, DIPHTHERIA-, PERTUSSIS-, MEASLES- and POLIOMYELITIS VACCINATIONS up to date.
• Anyone travelling to Africa, regardless of the duration and the conditions of the trip, should be protected against HEPATITIS A. Vaccination against TYPHOID is always recommended for people who are travelling in not very good hygienic conditions, or who go abroad frequently or for long periods (for example for more than 2 - 3 weeks), even if staying in good hygienic conditions. In a number of cases vaccination against HEPATITIS B is recommended as well.
For further details see the general text on VACCINATIONS.
• In specific circumstances vaccination against RABIES and MENINGOCOCCAL MENINGITIS ACWY should also be considered.
All this should be individually discussed with your doctor or with the doctor of the travel advice centre.