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Malaria Information and Prophylaxis, by Country [N]

The information presented in this table is consistent 1 with the information in the CDC Health Information for International Travel (the “Yellow Book,” New for 2018).
Click on the linked country name for a malaria map of that country.

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Country Areas with Malaria Estimated relative risk of Malaria for US Travelers2 Drug Resistance3 Malaria Species4 Recommended Chemoprophylaxis5 Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
Namibia Present in the regions of Kavango (East and West), Kunene, Ohangwena, Omusati, Oshana, Oshikoto, Otjozunjupa, and Zambezi.  Rare cases in other parts of the country. No malaria in city of Windhoek. Low Chloroquine P. falciparum >90%
P. malariae, P. ovale, and P. vivax rare		 Kavango (East and West), Kunene, Ohangwena, Omusati, Oshana, Oshikoto, Otjozunupa, and Zambezi: Atovaquone-proguanil, doxycycline, or mefloquine.  Other parts of the country with rare cases: Mosquito avoidance only. Province(s) of travel

Provinces of Namibia to determine if a city is within a certain province
Nauru None None Not Applicable Not Applicable Not Applicable
Nepal Present throughout country at altitudes below 2,000 m (6,562 ft). None in Kathmandu and on typical Himalayan treks. Low Chloroquine P. vivax 85%
P. falciparum 15%		 Atovaquone-proguanil, doxycycline, or mefloquine 1) City(ies) of travel
2) Altitude of city(ies) of travelAltitude information
Netherlands None None Not Applicable Not Applicable Not Applicable
Netherlands Antilles (Bonaire, Curaçao, Saba, St. Eustasius, and St. Martin) None None Not Applicable Not Applicable Not Applicable
New Caledonia (France) None None Not Applicable Not Applicable Not Applicable
New Zealand None None Not Applicable Not Applicable Not Applicable
Nicaragua Present in Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS).  Rare cases in Boaco, Chinandega, Esteli, Jinotega, Leon, Matagalpa, and Nueva Segovia.  No malaria in the city of Managua. Low None P. vivax 90%
P. falciparum 10%		 Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS): Atovaquone-proguanil, chloroquine, doxycycline, or mefloquine. Other areas with malaria: Mosquito avoidance only. Department(s) of travel

Map of departments of Nicaragua
Niger All High Chloroquine P. falciparum 85%
P. ovale 5-10%
P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Nigeria All High Chloroquine P. falciparum >85%
P. ovale 5-10%
P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Niue (New Zealand) None None Not Applicable Not Applicable Not Applicable
Norfolk Island (Australia) None None Not Applicable Not Applicable Not Applicable
North Korea Present in southern provinces No Data None Presumed to be 100% P. vivax Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7 Province(s) of travel

Map of provinces of North Korea
Northern Mariana Islands (US) Includes Saipan, Tinian, and Rota Island None None Not Applicable Not Applicable Not Applicable
Norway None 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. This estimate of risk is based on numbers of cases of malaria reported in US travelers and the estimated volume of travel to these countries. In some instances the risk may be low because the actual intensity of transmission is low in that country. In other instances, significant malaria transmission may occur only in small focal areas of the country where US travelers seldom go. Thus even though the risk for the average traveler to that country may be low, the risk for the rare traveler going to the areas with higher transmission intensity will of course be higher. For some countries that are rarely visited by US travelers, there is insufficient information to make a risk estimate.
3. Refers to P. falciparum malaria unless otherwise noted.
4. Estimates of malaria species are based on best available data from multiple sources.
5. 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.
6. This risk estimate is based largely on cases occurring in US military personnel who travel for extended periods of time with unique itineraries that likely do not reflect the risk for the average US traveler.
7. Primaquine can cause hemolytic anemia in persons with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Patients must be screened for G6PD deficiency prior to starting primaquine.

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