TABLE 1.
Risk of malaria in short-term travelers at different levels of endemicity in the indigenous population and mortality from malaria in short-term travelersa
| Annual incidence of malaria cases in local population | Example of area of endemicityb | Incidence per wk per 100,000 travelers | Incidence per 2 wk per 100,000 travelers without prophylaxis | Incidence per 2 wk per 100,000 travelers with prophylaxis assuming 90% efficacy of prophylaxis | Mortality per 100,000 travelers per 2 wk without prophylaxis | Mortality per 100,000 travelers per 2 wk with prophylaxis |
|---|---|---|---|---|---|---|
| 1 per 1,000 | Mexico, parts of South America, Vietnam (except Binh Province) | 1.9 | 3.8 | 0.4 | ||
| 10 per 1,000 | Parts of Vietnam (Binh Phuoc province) | 19.2 | 38.5 | 3.8 | ||
| 20 per 1,000 | Parts of India (Assam, Gujarat, Orissa, Rajastan) | 38.4 | 76.8 | 7.7 | 1 | |
| 50 per 1,000 | Parts of South Africa | 96.1 | 192.3 | 19.2 | 4 | |
| 100 per 1,000 | Western Africa | 192.3 | 384.6 | 38.5 | 8 | 0.5 |
a
Assuming a case fatality rate of 2%. Short-term travel is considered to be travel in a region of endemicity lasting 2 weeks or less.
b
The areas mentioned serve only as examples of areas with different levels of endemicity in the indigenous population. Risk in southeastern Asia is very unevenly distributed within each country and should be assessed at district levels based on the travelers' planned route and using malaria maps (30).