.png)
Which Countries have the Highest Malaria Risk?
Updated: Sep 1
Malaria remains a global health challenge. According to the World Health Report 2025, there were an estimated 282 million cases and 610,000 deaths in 2024 – Sadly about 9 million more cases than in 2023. Sub Saharan Africa bears 90% of this burden with 11 countries accounting for two thirds of all global cases and deaths.
In this article we'll explore:
What is Malaria?
Malaria is a parasitic infection found throughout the tropics. An infected mosquito can transmit malaria if you get bitten. It's the night time biting Anopheles species of mosquito that’s the culprit. Red blood cells get infected with the parasite and then spread further to distant organs like the liver, spleen and the brain.
Symptoms of Malaria
Common malaria symptoms can include:
Fever
Headache
Muscle and joint pains
Vomiting
Diarrhoea
If malaria becomes severe, you might also experience any of the following symptoms:
Drowsiness
Confusion
Dark urine
Jaundice
And even sepsis
But here’s what's important; if you develop fever symptoms such as sweats, chills, rigors, or simply feeling hot in a country with malaria risk you MUST follow these steps:
Ask for an urgent malaria test from a local doctor or clinic. Often it’s a simple lateral flow test and so you won't have to wait long for the results.
If your malaria test is positive, get urgent treatment. Depending on availability and your medical history, a doctor may offer you medications such as doxycycline, artemether with lumefantrine or even a treatment dose of atovaquone and proguanil.
Remember, malaria is very treatable providing you seek urgent medical advice promptly.
Malaria Risk by Country
90% of the world malaria cases occur in the Sahara African region. But do remember you’re also at risk in other parts of the world too. See malaria risk map for more details.
Malaria Risk Countries
Africa
Area | Country | Number of cases per year (millions) |
Nigeria | 68.5 | |
Cote D'Ivorie | 8.6 | |
Mali | 8.5 | |
Burkina Faso | 8.3 | |
Niger | 8.2 | |
Central Africa | Democratic Republic of Congo | 35.2 |
East Africa | Uganda | 13.2 |
Ethiopia | 12.4 | |
Tanzania | 9.4 | |
Southern Africa | Mozambique | 10.2 |
Please be aware that you're also at high risk in other popular tourist destinations such as Kenya, Zanzibar, Ghana, Gambia and Zimbabwe.
South America
The risk of malaria has vastly reduced over the last 15 to 20 years in South America due to vector (mosquito) control and prompt treatment of cases. However, you'll still be at risk in the following areas:
Guyana
French Guiana
Amazon basin
Haiti
South and South East Asia
Parts of India
Burma/ Laos/ Thailand border
West Papua (Indonesia)
Oceania
Papua New Guinea
Solomon Islands
Vanuatu
Malaria Risk Map
To give you a visual overview of malaria risk around the world, here is a guide. Please note that there are occasional cases of malaria in some countries where it’s stated ‘no risk’.
Who is Most at Risk of Malaria?
Some travellers are at a higher risk of severe malaria and therefore should have a lower threshold for taking anti-malarial prophylaxis. These include:
Children
Elderly
Pregnant women
Anyone with multiple medical problems
Individuals with a poor immune system
Anyone who does not have a spleen or it's poorly functioning, for example, in Coeliac disease
What Factors Increase the Malaria Risk?
Your risk of malaria varies by geography, season and any medical problems you may have. Factors that may increase malaria risk include:
Season – cooler periods are low risk, whereas rainy seasons usually increase risk
Altitude – malaria risk is reduced above 1200m
Forest/rural areas
Human development –creates new opportunities for mosquito breeding grounds
Flooding
Is the risk of malaria higher during the rainy season?
Absolutely. Rain creates pools of water and increases vegetation. These are ideal conditions for mosquito breeding.
How to Reduce the Risk of Malaria
You can drastically reduce your risk of malaria with a bit of careful planning and taking simple steps to protect yourself.
Before travel:
Plan your travel in the cooler season. This is perfectly fine for countries like Zimbabwe and South Africa
Avoid the rainy season or areas of flooding
Ask your travel health experts about malaria prevention tablets. Remember, you need to start these before you go
During travel, bite prevention and malaria prophylaxis:
Make sure you wear long sleeved clothing to act as a physical barrier for mosquito bites
Insect repellent are vital for protection. They need to contain ingredients that are known to be effective in clinical trials. These include DEET at a 50% concentration, Saltidin, Picardin or oil of lemon eucalyptus
Use mosquito nets, ideally impregnated with permethrin (an insecticide)
And of course make sure you take your tablets regularly!
After travel:
Don't forget to continue to take your malaria tablets as directed
Once you've returned from a country with malaria risk, you should seek urgent medical advice if you become unwell within one month. Malaria is very treatable providing you get tested and diagnosed early. You should do this even if you've had anti-malarial tablets
Read more about malaria prevention.
Anti-Malarial Tablets
We've already discussed anti-malaria tablets here briefly, for more information, visit our anti-malaria tablets service.
Protecting Yourself While Travelling
Remember, it's not always about, “What jabs do I need for such and such a country?…”.
Non-vaccine preventable conditions are also an important part of travel preparation. Think about sun protection and how you can protect yourself from heat exhaustion and heat stroke. Exposure to animals can put you at risk of other infectious diseases, not just rabies. If you’re in the unfortunate position of being bitten whilst abroad, take a look at our popular article on rabies vaccination after a dog bite how quickly should you act?
Wherever you're travelling, we feel it’s absolutely imperative that you get expert travel advice from a travel health specialist. You can get free advice from Health Klinix (vaccinations and products are charged) for a limited period. Call us on 02476 016519 to book an appointment.
Frequently Asked Questions
Are short-term tourists at risk of getting malaria?
The longer you stay in a malaria pandemic country, the higher your risk but even short-term travellers (1 week) have come back to the UK with severe malaria. Don't forget, it just takes one bite!
What are the malaria risk zones in sub-Saharan Africa?
Popular travel destinations like Nigeria, Gambia, Uganda and Tanzania are high risk. See table above for full details.
Are pregnant women at higher risk of getting malaria?
Absolutely. They are more likely to have severe malaria, premature delivery, pregnancy loss and profound anaemia. We generally recommend that pregnant women should not travel to countries with high malaria risk.
Are you more likely to get malaria in urban or rural destinations?
Generally, rural/forested areas increase your risk but in many countries, it's high risk even in urban areas, for example, Nigeria and Uganda.
Can you get malaria while taking antimalarials?
Taking appropriate and recommended anti-malarials drastically reduces your risk of malaria but does not completely eliminate it. So if you develop fever symptoms either during or for one month after your return, you must seek urgent medical advice, get tested and treated.
References
Written by:
Consultant in Infectious Diseases and Travel Medicine
MBBS, MRCP(UK), DTM&H, MRCGP, DCH, DRCOG, DFFP
Comments