Guidelines for malaria prevention in North Africa, the Middle East and Central Asia
The risk of malaria is very low in areas of North Africa and the Middle East that are most visited by tourists. For many of these areas, the best advice is to avoid mosquito bites, using measures such as mosquito repellents. Remember the remote possibility of malaria if you have a fever within a year of returning from these areas. This applies to all of North Africa (except for the El Faiyum area of Egypt, south-west of Cairo) and to Turkish tourist areas as far east as Antalya.
Chloroquine is recommended to prevent vivax malaria eastwards along the coast from Antalya to the Syrian border, and inland in South East Turkey. Chloroquine is also recommended in parts of Syria, Iraq and the former USSR.
Falciparum malaria, which is often resistant to chloroquine, occurs in some Emirates, parts of Saudi Arabia, Yemen, Iran, Afghanistan and parts of Oman (except Muscat, which is malaria free). Chloroquine plus proguanil is the recommended regimen for these areas.
| Risk | Country | Preferable regimen | Alternative regimen |
| Risk variable, chloroquine resistance present | Afghanistan (below 2000m, May-November) |
Chloroquine plus proguanil | Doxycycline |
| Risk low | Armenia (June-October). |
Chloroquine | Proguanil |
| Risk very low | Algeria |
Avoid mosquito bites |
Remember to tell your pharmacist:
- if you are pregnant, planning a pregnancy or breastfeeding
- if you suffer from any diseases or conditions
- if you are taking any regular medications
- if a child is travelling with you.
This information will help the pharmacist recommend the most appropriate regimen for you.
Remember to leave yourself enough time before you leave to obtain your medicines. All the malaria prevention medicines must be started before you travel. Mefloquine needs to be started two-and-a-half weeks before travel, chloroquine and proguanil should be started a week before, and Malarone and doxycycline one to two days before travelling.
Chloroquine (Avloclor or Nivaquine) and proguanil can be bought from pharmacies, but may have to be ordered in if you are going for a long trip. Mefloquine, doxycycline and Malarone all require a prescription from your doctor.
For these reasons always see your pharmacist at least three weeks before you plan to travel, to find out which (if any) medicines are recommended, when you need to start taking them, and whether you need a prescription to obtain them.
Remember to take your medicines regularly while you are away, and continue taking them for four further weeks after leaving the malarious area, with the exception of Malarone, which only needs to be continued for one week after leaving.
Always suspect malaria and seek urgent medical advice if you develop a fever or flu-like illness whilst you are away (even if you are taking preventive medicines) or up to a year after you return, in particular in the first three months.
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