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Malaria in Africa: which preventive medication, and how to protect yourself
Malaria is present in 21 of the 26 French-speaking African countries. Your preventive medication is chosen with a doctor or travel clinic before you leave. On the ground: repellent, an insecticide-treated net and covering clothes in the evening. Any fever after you get home means seeing a doctor urgently.
Malaria prevention in Africa starts with one fact: malaria is present in 21 of the 26 French-speaking African countries. That covers all of West and Central Africa, plus Mauritania, Rwanda, Burundi, Djibouti, Madagascar and the Comoros. No preventive medication suits everyone. A doctor or travel clinic chooses it with you before you leave, based on your destination, trip length, age, any pregnancy, your medical history and your other medicines. On the ground, avoiding bites is essential, and any fever after you get home means seeing a doctor urgently.
This article is not medical advice. It sums up what health authorities say (the WHO, the US CDC, the UK and Canadian authorities, and France's official recommendations from the HCSP) to help you prepare for your appointment.
Malaria prevention in Africa: what to know before you go
Malaria is caused by a parasite spread by the bite of an infected female Anopheles mosquito. In sub-Saharan Africa, the main species is Plasmodium falciparum, the one behind severe cases, the Public Health Agency of Canada points out.
According to the WHO fact sheet dated December 4, 2025, there were about 282 million cases and 610,000 deaths worldwide in 2024. The WHO African Region accounts for 95% of them. Children under 5 make up about three in four deaths there.
The first symptoms are fever, headache and chills. They usually appear 10 to 15 days after the bite, the WHO says. They look like the flu, which is what makes malaria so easy to miss once you are home.
Which French-speaking African countries are affected?
The table cross-checks the UK's 2026 guidelines (UKHSA), the Institut Pasteur's country pages, France Diplomatie and the WHO list of countries certified malaria-free. Click a country to read its full Health section.
North and West Africa
| Country | Malaria | Details and source |
|---|---|---|
| Morocco | No | Certified malaria-free by the WHO in 2010; Institut Pasteur: no transmission |
| Algeria | No | Certified malaria-free by the WHO in 2019; Institut Pasteur: no transmission |
| Tunisia | No | Institut Pasteur: no transmission |
| Mauritania | Yes, by area and season | Year-round in the south; in the north, high risk from July to October (UKHSA, Institut Pasteur) |
| Senegal | Yes, whole country | High risk (UKHSA); somewhat lower from January to June in the west-central region (France Diplomatie) |
| Mali | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Burkina Faso | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Niger | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Guinea | Yes, whole country | High risk (UKHSA) |
| Côte d'Ivoire | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Togo | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Benin | Yes, whole country | High risk (UKHSA, France Diplomatie) |
Central Africa, the Horn of Africa and the Indian Ocean
| Country | Malaria | Details and source |
|---|---|---|
| Cameroon | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Chad | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Central African Republic | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Equatorial Guinea | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Gabon | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Republic of the Congo | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| DR Congo | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Rwanda | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Burundi | Yes, whole country | High risk (UKHSA), especially from December to May (France Diplomatie) |
| Djibouti | Yes | High risk (UKHSA), year-round (France Diplomatie) |
| Madagascar | Yes, whole country | Year-round (Institut Pasteur), high risk (UKHSA) |
| Comoros | Yes, whole country | High risk (UKHSA, France Diplomatie) |
| Seychelles | No | Institut Pasteur: no transmission |
| Mauritius | No | Certified malaria-free by the WHO in 1973; Institut Pasteur: no transmission |
Mauritania, a special case
For Mauritania, the sources do not say quite the same thing. The Institut Pasteur excludes the Dakhlet-Nouadhibou and Tiris-Zemmour regions, and reports seasonal transmission in Adrar and Inchiri from July to October. The UK authorities rate the whole north as high risk from July to October. We go with the more cautious view: anywhere in the country, the rainy season matters.
No malaria, but still mosquitoes
Countries without malaria still have mosquitoes. Dengue and chikungunya circulate in the Seychelles and Mauritius, and West Nile virus in Tunisia, according to our country pages. Our health guide to French-speaking Africa covers yellow fever and the other vaccines.
Preventive malaria medication: a decision for your doctor
Preventive medication is called chemoprophylaxis. It is not a vaccine: it is a drug you take before, during and after your trip. You should not pick it on your own, or on the advice of a friend who took it once.
Book an appointment with your doctor or a travel clinic. The Government of Canada advises seeing a provider ideally six weeks before you leave. That leaves time for vaccines and, for some drugs, for starting the medication early.
The doctor weighs several things:
- your exact destination, the season and the type of trip (cities, the bush, nights in rural areas);
- how long you are staying;
- your age, a child's weight, any pregnancy or breastfeeding;
- your health conditions, your history (psychiatric conditions, epilepsy) and your other medicines;
- antimalarials you have tolerated well or badly in the past.
Watch out
Do not leave without medical advice, even for a short trip. France's 2026 recommendations reworked their malaria chapter to support this choice: only a health professional can tailor it to you.
The three drugs named by health authorities
For most sub-Saharan African countries, official sources name the same three options: atovaquone-proguanil, doxycycline and mefloquine. That is the case for the UK authorities, the Public Health Agency of Canada and France's 2026 recommendations from the High Council for Public Health (HCSP). The Canadian agency notes that in most regions of the world, the parasite is resistant to chloroquine.
Each drug has its own constraints, especially its timing. The table below sums up what official sources say. It does not replace a prescription: only your prescriber sets the schedule, and we give no doses.
| Drug | When to start, by source | How long after leaving the malaria area |
|---|---|---|
| Atovaquone-proguanil | 1 day before (WHO); 1 to 2 days before (CDC, Canada); 24 to 48 hours before (HCSP 2022) | 7 days (all sources) |
| Doxycycline | The day before (WHO, HCSP 2022); 1 to 2 days before (CDC, Canada) | 4 weeks (all sources) |
| Mefloquine | 10 days before (HCSP 2022); at least 1 week, preferably 2 to 3 (WHO) | 3 weeks (HCSP 2022); 4 weeks (CDC, Canada, WHO) |
For mefloquine, sources differ on how long to continue after you return. We keep the most cautious rule, four weeks, but your doctor decides.
Main contraindications, according to the CDC
The CDC sums up the main limits of each drug:
- atovaquone-proguanil cannot be used during pregnancy, or while breastfeeding a baby under 5 kg;
- doxycycline cannot be used during pregnancy or by children under 8;
- mefloquine can be used during pregnancy, but not by people with certain psychiatric conditions or a seizure disorder.
These general rules are not enough to decide. They explain why your doctor asks so many questions.
Our advice
Before the appointment, write down your exact dates, the regions you will visit, any nights outside cities and the list of your medicines. A well-suited prescription depends on it.
Standby treatment: on prescription only
For some very remote trips, a doctor may prescribe emergency standby treatment, to take only if you have a fever and cannot get care. According to the summary of the French recommendations published by VIDAL, it remains exceptional: for when no care is possible within 12 hours, after at least 7 days in a malaria area. You must then see a doctor as soon as possible.
The UK authorities add that it does not replace preventive tablets. The French recommendations also warn that medicines bought abroad may be counterfeit. Get your medication at home, on prescription.
Avoiding Anopheles mosquito bites
No drug offers 100% protection, so bite avoidance is the first line of malaria prevention in Africa, with or without tablets.
From sunset to sunrise
Anopheles mosquitoes bite mainly between dusk and dawn, according to the malaria chapter of the WHO guide published by Spain's Ministry of Health. The UK authorities add that biting by several major malaria vectors in Africa peaks at and just after midnight. They also warn that risk exists at other times, for example in forests or on overcast days.
In practice, protect yourself from nightfall onward, over dinner on the terrace as well as through the night.
Repellents and their strengths
Choose a skin repellent based on a recognized active ingredient, and apply it to exposed skin. The French recommendations say to use only authorized products. Here are the usual strengths for adults, as given by France's 2026 recommendations (summarized by MesVaccins.net) and the UK's 2026 guidelines.
| Ingredient | France, HCSP 2026 (adults) | UK, UKHSA 2026 |
|---|---|---|
| DEET | 20 to 50% | 50%, first choice |
| Icaridin (picaridin) | 20 to 30% | 20% |
| IR3535 | 10 to 30% | Needs reapplying more often than DEET |
| PMD (citriodiol, lemon eucalyptus) | Not detailed in the summary we read | The only plant-based repellent recommended |
For children or during pregnancy, the allowed ingredients and strengths are more limited. Ask your doctor or pharmacist before you buy.
Nets and clothing
At night, sleep under an insecticide-treated mosquito net in good condition. The UK authorities recommend one for all travelers to malaria areas, unless the room is air-conditioned or properly screened. France's 2026 recommendations also advise a net over a baby's crib or stroller.
In the evening, wear long, light-colored clothes. On treating clothing with insecticide, sources differ: the UK authorities suggest it, while France's 2026 recommendations no longer advise it. Discuss it with your doctor.
There is currently no commercially available malaria vaccine for travellers.
What about malaria vaccines?
Two vaccines exist, RTS,S and R21. The WHO recommends them for young children living in areas with moderate to high malaria transmission, as part of childhood immunization. They are not meant for travelers, and they replace neither preventive tablets nor bite avoidance.
Fever during or after your trip: an emergency
Any fever during your stay or after you return should make you think of malaria, even if you took your tablets correctly. See a doctor without delay, the same day, and say that you have been in a malaria area.
The WHO chapter published by Spain's Ministry of Health and the French recommendations refer to 3 months after return. The UK and Canadian authorities go further: up to one year after travel. We keep the most cautious rule. The Institut Pasteur de Lille notes that about 3% of falciparum malaria cases appear more than two months after return.
Watch out
Fever, chills or headache after a trip to a malaria area, even with other symptoms: go to the emergency room or see a doctor the same day. Do not treat yourself, and do not take leftover tablets without advice.
While traveling, go to a reputable health center. Insurance that covers medical costs and repatriation is essential: care is very limited in several countries, as our country pages point out.
A few special cases
Long stays
For a stay of several months, tell your doctor as soon as you start planning. Trip length is one of the criteria for choosing the medication, according to France's 2026 recommendations.
Traveling with children or while pregnant
The WHO counts young children and pregnant women among those most at risk of severe malaria. A specialist consultation is essential, and some drugs or repellents are ruled out for them, as the CDC rules above show.
Safaris and hikes
Outings in the bush often start early in the morning and sometimes end after sunset, when Anopheles mosquitoes bite. That is the case for gorilla trekking in Rwanda, a country where malaria is present everywhere. In Madagascar, there is no risk-free season either.
Our advice
Pack repellent and a long-sleeved jacket in your day bag for the ride back at sunset. For malaria prevention in Africa, that is often the most exposed hour of the day.
Check your own government's travel advice too. Each country's entry rules, including yellow fever, are on our entry requirements pages.
Frequently asked questions
Do I need malaria tablets for a short trip to Africa?
In the countries south of the Sahara, the UK authorities rate the risk as high and recommend preventive medication. Trip length is one of the criteria, but your doctor makes the call, based on your itinerary and your health.
Can I buy antimalarials locally?
It is not advisable, in Africa or anywhere else. The French recommendations warn that medicines bought abroad may be counterfeit. And most regimens start before departure.
Do Morocco, Tunisia or Mauritius require malaria tablets?
No. The Institut Pasteur reports no malaria transmission in Morocco, Algeria, Tunisia, the Seychelles or Mauritius, and no preventive medication. Repellents are still useful against other mosquito-borne diseases.
Does artemisia tea protect against malaria?
No. As early as 2019, France's HCSP pointed out that artemisia teas, capsules and other derivatives have not been proven effective, and that their safety is not established. Our country pages say it too: the tea sold locally does not protect you.