Afghanistan
Malaria

Afghanistan: General Health Risks

Malaria

Malaria is transmitted by the night-time - dusk to dawn - biting female Anopheles mosquito.

Persons travelling overland from and to Pakistan or working in refugee camps should also take one of the anti-malarial medication regimens below.


Malaria Map (WHO 2020)

Risk is present in the whole country. Very small risk in Kabul. High risk in the east.

High risk months for Malaria are: May to November

Incidence of Plasmodium falciparum Malaria: 5%

Areas with drug resistant Malaria: Malaria risk due to P. falciparum (5%) and P. vivax (95%) exists from May through November below 2500 m. Higher risk in eastern provinces bordering Pakistan.Source: WHO 2020. Chloroquine resistant P. falciparum malaria is present in all malarious areas of Afghanistan. The antimalarial medications listed below are effective for this country. Malaria risk is present in the whole country.

All malaria infections are serious illnesses and must be treated as a medical emergency. In offering guidance on the choice of antimalarial drugs, the main concern is to provide protection against Plasmodium falciparum malaria, the most dangerous and often fatal form of the illness.

Regardless of the medication which has been taken, it is of utmost importance for travellers and their physician to consider fever and flu-like symptoms appearing 7 days up to several months after leaving a malarious area as a malaria breakthrough. Early diagnosis is essential for successful treatment.

In addition to the suggested antimalarial medication, use a mosquito bed net and effective repellents to avoid the bite of the nocturnal Anopheles mosquito.

The medications listed below are effective against malaria in this country. Discuss with your healthcare provider which antimalarial regimen is best suited to your needs. Take ONE of the following:

Atovaquone-proguanil

Brand names: Malarone, Malanil and others; generics available.

TAKE 1 TABLET DAILY (ATOVAQUONE 250 mg + PROGUANIL 100 mg).

START 1-2 DAYS BEFORE ENTERING THE MALARIOUS AREA, CONTINUE DAILY DURING YOUR STAY AND CONTINUE FOR 7 DAYS AFTER LEAVING.

Note: Take at the same time every day with food or milk.

Doxycycline

Brand names: Vibramycin and others; generics available.

TAKE 1 TABLET DAILY OF 100 mg.

START 1 DAY BEFORE ENTERING MALARIOUS AREA, CONTINUE DAILY DURING YOUR STAY AND CONTINUE FOR 4 WEEKS AFTER LEAVING.

Note: When taking this drug, avoid exposure to direct sunlight and use sunscreen with protection against long range ultraviolet radiation (UVA) to minimize risk of photosensitive reaction. Take with large amounts of water to prevent esophageal and stomach irritation.

Mefloquine hydrochloride

Brand names: Lariam, Mephaquin, Mefliam and others; generics available.

TAKE 1 TABLET OF 250 mg (228 mg base) ONCE A WEEK.

START 1-2 WEEKS BEFORE ENTERING THE MALARIOUS AREA, CONTINUE WEEKLY DURING YOUR STAY AND CONTINUE FOR 4 WEEKS AFTER LEAVING.

Note: Side effects include nausea and headache, including neurological side effects such as dizziness, ringing of the ears, and loss of balance.  Psychiatric side effects include anxiety, depression, mistrustfulness, and hallucinations. Neurological side effects can occur any time during use and can last for long periods of time or become permanent even after the drug is stopped. Seek medical advice if any neurological or psychiatric side effects occur.

For further details, cautions, contraindications, or alternatives, including guidelines for pediatric dosages and Emergency Self Treatment, download IAMAT's whitepaper How to Protect Yourself Against Malaria.

The recommendations for malaria prophylaxis outlined here are intended as guidelines only and may differ according to where you live, your health status, age, destination, trip itinerary, type of travel, and length of stay. Seek further advice from your physician or travel health clinic for the malaria prophylactic regimen most appropriate to your needs.