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Table of Vaccines & Malarial Prevention

Click on the required region of the map below for a list of countries in that region The countries in the data tables are divided into their respective continents. Each list of countries is then arranged in alphabetical order for ease of use. There are six continental tables altogether. To access the data, click on the continent in which the country you require is found and you will be taken to the appropriate page. The information contained in the tables is regularly updated using a number of reference sources. The data in the tables only applies to healthy adults who are not taking any other medications. Travellers will need to consult their own doctor or a travel clinic to arrange to have the relevant vaccinations. The information supplied is not designed for use by pregnant women, nursing mothers, children or persons suffering from epilepsy or any other chronic condition. Those people should consult with their doctor before taking malaria tablets. Notes on Malaria Prophylaxis The 1st Regimen is the preferred regimen for a country. The 2nd Regimen is an alternative that should only be used when the 1st Regimen is either unavailable or badly tolerated. When two different regimens appear together in the same country, they are area specific and more information about the region can be found in the text.   The advice on malaria prophylaxis is primarily designed for short visits (three months or less) to a particular region. The lists are by no means exhaustive and are for quick reference purposes. Where a country is shown as requiring anti-malarial prophylaxis it should be noted that a specific area may be at risk and not the whole region. Many urban areas in otherwise malarious zones have little or no risk e.g. Bangkok city is regarded as a no risk area but is surrounded by rural areas of high risk. There is generally little risk in rural areas above an altitude of 1500 metres. Malarone has recently become licensed in the UK for malaria prophylaxis and is now recommended for use in those countries where Doxycycline and Mefloquine are currently indicated. It is licensed for stays of up to 28 days but can be used for stays of up to three months. It should be started one or two days before departure and continued for one week after return. The tables below are reproduced on each of the regional pages and include a key to the abbreviations used and information on the different anti-malarial drug regimens.

YEL Yellow Fever HEP A Hepatitis A TYP Typhoid TET Tetanus POL Polio MEN Meningitis ENC Encephalitis B DIP Diphtheria RAB Rabies HEP B Hepatitis B M Vaccination is mandatory and a certificate of vaccination is required for entry. C A certificate of vaccination may be required if entering from an endemic country, (except for children <1 year old). R Vaccination is recommended for the country but no evidence is required for entry. L Long Term. Vaccination recommended for travellers staying in endemic areas for 3 months or more.   Countries requiring malaria prophyllaxis should be regarded as being at risk all year round and you should also assume that the whole country is at risk unless otherwise indicated. The 1st malaria regimen (MAL 1) is the preferred regimen for a country. The 2nd malaria regimen (MAL 2) is an alternative that should only be used when the 1st Regimen is either unavailable or badly tolerated. The preferred regimen should always be used whenever possible. Use of the 2nd regimen in some instances may not provide adequate cover. When there are two different regimens for the same country, they are area specific. Read the text to find out which regimen is suitable for the area you require. Where regimen 1 is indicated there is Chloroquine resistance in that region and it is very likely to be the Falciparum malaria which is the most serious form of the disease. In this instance it is vitally important that travellers take adequate prophylaxis. Remember:- No prophylaxis is 100% effective but not taking anti-malarials where they are indicated will put you at greater risk should you get the disease. Malaria is a killer!   The Different Drug Regimens Regimen 1 Mefloquine one 250mg tablet weekly. OR Doxycycline one 100mg capsule daily. OR Malarone one tablet daily. Regimen 2 Chloroquine 300mg weekly (2x150mg tablets). PLUS Proguanil 200mg daily (2x100mg tablets). Regimen 3 Chloroquine 300mg weekly (2x150mg tablets) OR Proguanil 200mg daily (2x100mg tablets). Regimen 4 No prophylactic tablets required but anti mosquito measures such as insect repellents, mosquito nets, long sleeved clothing, etc. should be strictly observed. .   Proguanil 100mg tablets are supplied as Paludrine Tablets Chloroquine 150mg tablets are supplied as Nivaquine or Avloclor Tablets Mefloquine 250mg tablets are supplied as Lariam Tablets   Malarone is a combination of Atovaquone 250mg and Proguanil 100mg   Length of Prophylaxis Chloroquine, Proguanil & Maloprim Start one week before travel, throughout your stay in an endemic area and continue for four weeks after return. Mefloquine (Lariam) Start two and a half weeks before travel, throughout your stay in an endemic area and continue for four weeks after return. Doxycycline Start two days before travel, throughout your stay in an endemic area and continue for four weeks after return. Malarone Start two days before travel, throughout your stay in an endemic area and continue for one week after return. IMPORTANT! Take the tablets absolutely regularly, preferably with or after a meal.   Long Term Use of Anti-Malaria Drugs Chloroquine May be taken for periods exceeding five years. Paludrine May be taken for periods exceeding five years. Maloprim Can be taken for periods up to one year. Mefloquine Can be taken for periods up to one year. Doxycycline Can be taken for periods up to six months. Malarone Can be used for travel periods up to three months.   Compatibility of Anti-Malaria Drugs   Pregnancy Breast Feeding Epilepsy Psoriasis Altitude Scuba Diving Chloroquine OK OK NO NO OK OK Paludrine OK OK OK OK OK OK Mefloquine OK* NO NO OK NO NO Doxycycline NO NO OK OK OK OK Malarone NO NO OK OK OK OK * These drugs are not suitable during the first trimester of pregnancy.   Childrens' Dosages: Calculate the dose by weight rather than by age if possible Age/Weight Chloroquine (once weekly) Proguanil (once daily) Mefloquine (once weekly) Doxycycline (once daily) Malarone (once daily) 0 - 12 weeks under 6kg ¼ tablet ¼ tablet - - - 3 - 12 months 6 - 10kg ½ tablet ½ tablet ¼ tablet - - 1 - 3 years 10 - 16kg ¾ tablet ¾ tablet ¼ tablet - 1 child's tablet 4 - 7 years 16 - 25kg 1 tablet 1 tablet ½ tablet - 1 child's tablet 8 - 12 years 25 - 45 Kg 1½ tablets 1½ tablets ¾ tablet - 2 child's tablets 13 years and over 45kg and over 2 tablets 2 tablets 1 tablet 1 capsule 1 adult tablet The above dosages are based upon the guidelines issued by the Advisory Committee on Malaria Prevention.   Adult Dosages Regimen Dose for Chemoprophylaxis Usual amount per tablet (mg) Areas without drug resistance: Chloroquine Proguanil 2 tablets weekly 2 tablets daily 150mg (base) 100mg Areas of little chloroquine resistance (poorly effective where marked resistance): Chloroquine plus Proguanil 2 tablets weekly 2 tablets daily 150mg (base) 100mg Areas of chloroquine resistant P. falciparum: Mefloquine Doxycycline Malarone (atovaquone & proguanil) 1 tablet weekly 1 tablet/capsule daily 1 tablet daily 250mg (228 in USA) 100mg 250mg atovaquone & 100mg proguanil