Where are the high-risk areas for Malaria?

In this article, we’ll explore the high-risk areas for malaria and why certain regions are more affected. We’ll discuss where malaria is most prevalent around the world, the factors that contribute to these areas being at high risk and how climate, geography and socio-economic factors play a role. We’ll also look at practical ways to reduce your risk of contracting malaria, including preventive measures and strategies for staying safe while travelling.

Key Takeaways

Here are the five biggest takeaways from this article about the high-risk areas of Malaria:

• Malaria is most common in tropical and subtropical regions near the equator. Sub-Saharan Africa has the highest number of cases. Still, other high-risk areas include Central and South America, Southeast Asia, Oceania, the Eastern Mediterranean, the Caribbean, the South Pacific and parts of the Middle East.

• Warm temperatures, high humidity, and frequent rainfall create the ideal breeding grounds for malaria-carrying Anopheles mosquitoes.

• Spending time outdoors during the evening and nighttime, staying in accommodations without mosquito protection, and longer stays in malaria-endemic regions significantly increase the likelihood of contracting malaria.

• Practical steps to reduce malaria risk include using insecticide-treated bed nets, wearing protective clothing, applying insect repellents, staying in mosquito-proof accommodations and taking anti-malarial medications as prescribed by a healthcare provider.

• While some regions, such as the UAE and Egypt, have successfully eradicated malaria, many high-risk areas continue to face challenges, including drug resistance, geographical isolation and limited resources.

Where is Malaria most common across the world?

Malaria is most common in tropical regions near the equator, where warm temperatures and high humidity provide the perfect conditions for mosquitoes to thrive. Sub-Saharan Africa has the highest number of malaria cases, along with other high-risk areas including parts of Central and South America, Southeast Asia, and Oceania.

Regions in the Eastern Mediterranean, the Western Pacific, the Caribbean, the South Pacific, and the Middle East also have a significant number of malaria cases. These areas are particularly vulnerable due to their climate, mosquito populations and issues with access to healthcare and prevention measures.

If you are travelling to any of the areas listed below, it is important to take the necessary precautions. Consult with your doctor before you travel to ensure you stay safe.

Central and South America

Malaria is a public health concern in parts of Central and South America, with the Amazon Basin being the most affected region. The dense rainforest, warm climate and frequent rainfall create an ideal environment for mosquitoes that transmit malaria. While some areas have made progress in controlling the disease, areas of high transmission persist, particularly in remote regions with limited access to healthcare.

Southeast Asia

Malaria poses a significant health threat in Southeast Asia, which carries the second-highest burden of malaria cases globally. In 2022, the region reported approximately 5 million confirmed cases, with India, Indonesia and Myanmar experiencing the highest numbers. Factors such as dense populations, favourable climates for mosquitoes and gaps in healthcare access contribute to malaria in this region.

The Eastern Mediterranean

Malaria remains an issue in the Eastern Mediterranean Region (EMR), affecting countries such as Pakistan, Afghanistan, Sudan, Somalia and Yemen. In 2022, the region recorded an estimated 8.3 million malaria cases, up from 6.2 million in 2021. Malaria mortality in the region is varied, with an estimated 10,100 deaths reported in 2019, down from 15,000 in 2010.

The Western Pacific

Malaria is also prevalent in the Western Pacific region, particularly in countries such as Papua New Guinea, Solomon Islands and Vanuatu. The region’s warm, humid climate provides ideal conditions for mosquito breeding, leading to significant malaria transmission in these areas. Papua New Guinea alone accounts for the majority of malaria cases in the region.

Parts of the Caribbean

In the Caribbean, malaria is most common in the Greater Antilles islands, Trinidad and Tobago and Martinique. While the region as a whole has lower malaria transmission compared to other tropical areas, these specific locations are vulnerable due to favourable conditions for mosquito breeding. Warm temperatures, humid climates and stagnant water sources provide an ideal environment for malaria-carrying mosquitoes.

The South Pacific

Malaria remains a significant health concern in the South Pacific. The region’s tropical climate, characterised by high temperatures and frequent rainfall, is ideal for mosquitoes. Despite ongoing efforts to combat malaria, challenges such as drug resistance, geographical isolation and limited resources continue to halt progress.

The Middle East

Malaria is a public health concern in certain parts of the Middle East, though most countries in the region are now malaria-free. Countries such as the United Arab Emirates (certified malaria-free in 2007) and Egypt (certified malaria-free in 2024) have successfully eliminated the disease. However, imported cases remain an issue, particularly due to foreign workers travelling from malaria-endemic areas.

Image Source: ECDC

Why are these areas at high risk?

Malaria is most common in regions where the climate and geography create optimal conditions for the disease to live and spread. Tropical and subtropical areas near the equator, such as sub-Saharan Africa, Southeast Asia, and the Amazon Basin, experience warm temperatures, high humidity, and frequent rainfall. These factors provide ideal breeding grounds for Anopheles mosquitoes, the main carriers of malaria.

As well as environmental factors, socio-economic issues and healthcare limitations significantly contribute to malaria risk. Many high-risk regions also lack access to prevention tools such as insecticide-treated bed nets, anti-malarial medications like Malarone and Atovaquone/Proguanil, as well as diagnostic tests.

Poverty, inadequate housing and human movement, including migration from regions with malaria, may also lead to imported cases.

Factors that affect the risk of getting malaria

Several factors influence the risk of contracting malaria, particularly when travelling or living in malaria-endemic areas. Some of the most significant factors that affect the chances of getting malaria include:

• The duration of stay: Longer stays in regions where malaria is common increase the likelihood of being bitten by an infected mosquito.

• Time of day: Malaria-transmitting Anopheles mosquitoes are most active during the evening and nighttime.

• Activities: Activities that involve spending time outdoors in the evenings, such as eating outside or camping, expose individuals to mosquitoes when they are most active.

• Accommodation: The type of accommodation can influence the level of protection against mosquito bites. 

How can you reduce the risk of getting malaria?

Reducing the risk of getting malaria involves a combination of preventive measures. One of the most effective ways to protect yourself is by using insecticide-treated bed nets (ITNs), especially when sleeping in malaria-endemic areas. These nets create a physical barrier and kill mosquitoes that come into contact with them. Another physical tip to follow is to wear protective clothing such as long-sleeved shirts, trousers and socks, particularly in the evening and at night. Applying insect repellents to exposed skin can also provide an additional layer of protection.

Staying in accommodations with window screens, air conditioning, or mosquito nets is essential, as these features reduce the likelihood of mosquitoes entering your living space.

For travellers, taking anti-malarial medications as prescribed by a healthcare provider is a crucial preventive strategy. These medications should be taken before, during and after travel to ensure complete protection, depending on the medication and its specific dosing instructions.

Finally, avoiding outdoor activities during peak mosquito hours can help minimise exposure.

Final Thoughts

Malaria remains a significant global health concern, particularly in tropical and subtropical regions where the climate and geography create ideal conditions for mosquito breeding. Areas such as sub-Saharan Africa, Southeast Asia and the Amazon Basin experience the highest rates of transmission, while other regions like the Eastern Mediterranean, the Western Pacific and parts of the Caribbean and Middle East also face ongoing cases. Factors such as socio-economic conditions, healthcare access and human movement further contribute to the persistence of malaria in these regions.

With proper knowledge and precautions, the risk of contracting malaria can be significantly reduced. Preventive measures such as using insecticide-treated bed nets, wearing protective clothing, applying insect repellents and taking anti-malarial medications are essential, especially for travellers to high-risk areas.

Further Reading

Malaria - NHS

Malaria - World Health Organisation