Avoiding Malaria in Uganda – Travel Risk, Precautions and Guidelines


27 Mar 2024

Known for its diverse ecosystems ranging from the snow-capped Rwenzori Mountains to the immense Lake Victoria, Uganda offers unparalleled natural beauty and wildlife experiences. 

However, it’s also a hotspot for malaria. 

The disease is a major health concern across the country, with no area being completely free from risk. Understanding the dynamics of malaria transmission, including environmental and biological factors, is crucial for all travelers planning to visit Uganda.

Malaria Transmission and Risk Factors

Malaria transmission occurs when an Anopheles mosquito, infected by feeding on a person with malaria, bites another person. 

The risk of malaria transmission is influenced by a couple factors:

  • Climate, with warmer and wetter conditions favoring mosquito breeding. 
  • Areas around lakes and marshlands, and rural regions with inadequate drainage and standing water, are particularly high-risk zones. 

However, urban areas are not exempt; the presence of stagnant water can create breeding grounds even in cities.

Areas in Uganda with High Malaria Risk

In Uganda, the risk of malaria is universally high, but it intensifies in the regions surrounding Lake Victoria and in the northwest and west, close to the Congo and South Sudan borders. 

These areas are characterized by significant mosquito populations due to favorable breeding conditions. 

Despite this, even higher elevation areas, traditionally considered lower risk, have reported malaria cases, underscoring the need for vigilance regardless of your location in Uganda.

Malaria Precautions to Take in Uganda

Prevention of malaria involves a combination of 1) measures to avoid mosquito bites and 2) the use of prophylactic antimalarial medications, which are essential given the high transmission rates throughout Uganda.

1) Antimalarial Medications

Prophylactic antimalarial medications are a key component of malaria prevention. 

The choice of medication should be made in consultation with a healthcare provider, taking into account the traveler’s health history, the duration of the visit, and any drug resistance in the malaria strains prevalent in specific regions of Uganda. 

Common choices include:

  • Atovaquone-Proguanil (Malarone)
  • Doxycycline
  • Mefloquine

Malarone tends to be favored by doctors and travelers – especially with convenient & affordable telehealth options like Runway Health offering free doorstep delivery.

Get Anti-Malaria Prescription

Starting the medication regimen before arrival in Uganda allows the body to adjust and ensures protection from the moment of potential exposure.

2) Personal Protective Measures

Beyond medication, personal protection against mosquito bites is critical. This includes:

  • Insect repellent: Use EPA-registered insect repellents containing DEET, picaridin, IR3535, or oil of lemon eucalyptus on exposed skin and clothing.
  • Protective clothing: Wearing long-sleeved shirts, long pants, and socks, preferably treated with permethrin, reduces skin exposure.
  • Mosquito nets: Sleeping under long-lasting insecticidal nets (LLINs) can significantly decrease the chances of being bitten at night.
  • Behavioral practices: Since mosquitoes are most active from dusk to dawn, minimizing outdoor activities during these hours or ensuring protective measures are in place can further reduce the risk.

Seeking a Prescription for Antimalarials

Preventative malaria tablets cannot be obtained over the counter – but there are convenient options to obtain a prescription.

Consult a Physician

Obtaining a prescription for Malarone has been simplified by telehealth services, which provide consultations and prescriptions online.

Runway Health, among others, offers this service, delivering medication directly to your door and providing cost transparency – which is particularly beneficial for travelers arranging last-minute trips or those in remote areas.

Are Side Effects a Concern?

While side effects can be a concern, they are generally mild and manageable. Travelers should discuss any apprehensions with their healthcare provider and weigh these against the risk of contracting malaria. It’s important to continue taking the prescribed medication for the duration recommended, as stopping early can leave you unprotected and susceptible to infection.

Local Healthcare System and Malaria Treatment Availability

Uganda has made significant strides in malaria treatment and prevention. Most towns and cities have medical facilities capable of diagnosing and treating malaria. 

However, remote areas may have limited resources, and it’s advisable for travelers to carry a basic medical kit including antimalarial drugs for emergency self-treatment, especially when traveling far from urban centers.

Emergency Planning and Resources

Create a plan in case of malaria symptoms, which include fever, chills, headaches, and muscle aches, similar to flu symptoms. If you suspect you’ve contracted malaria:

  • Seek Immediate Medical Attention: In cities and larger towns, hospitals and clinics can perform a blood test to confirm malaria and provide treatment. If you’re in a remote area, seek medical assistance in Uganda, or a travel health insurance provider for advice on the nearest facility.
  • Travel Health Insurance: See if your policy covers medical treatment for malaria and medical evacuation. Knowing the details of your coverage and having contact information handy can expedite access to care.
  • Consider a Travel Medical Kit: If immediate professional medical care isn’t available, start treatment with the emergency antimalarial drugs in your kit while arranging to get to a healthcare facility.

Advice for Specific Travelers Groups

Special precautions are necessary for certain groups due to heightened risk or the need for different prophylactic approaches.

Elderly Travelers

Older adults may have a higher risk of severe malaria if infected, and they often have other underlying health conditions that could be exacerbated by malaria or its treatment. 

They may also be more susceptible to side effects from antimalarial medications due to age-related changes in drug metabolism and excretion. Depending on health history, specific medication and travel region, a physician can help determine an optimal health approach.

Travelers Taking Regular Medication

While antimalarials like malarone are generally tolerable, drug interactions can sometimes occur.

This may include individuals on treatments for:

  • Psychiatric conditions
  • Epilepsy
  • Blood thinners
  • Any other long-term medication regimes

As always, be transparent with your doctor, and follow instructions and guidelines closely. This can help ensure a smooth, enjoyable trip without health complications.

Travelers with Pre-Existing Medical Conditions: 

Individuals with chronic diseases such as diabetes, heart disease, or immune-compromising conditions (including HIV/AIDS patients) may have an increased risk & intensity of symptoms. 

As mentioned above, interactions between antimalarial medications and drugs taken for chronic conditions can occur. These travelers should have a detailed discussion with their healthcare provider about the safest and most effective malaria prevention strategies tailored to their health status.


Children are particularly vulnerable to severe malaria. For families traveling with children, it’s crucial to use child-appropriate mosquito repellents, ensure sleeping areas are protected with nets, and dress children in protective clothing. Pediatric dosages of antimalarial medication should be discussed with a healthcare provider.

Pregnant Women

Malaria in pregnancy can lead to serious complications, including maternal and fetal morbidity. 

It’s generally recommended pregnant women avoid malaria-prone regions if possible, but if absolutely needed, make sure to discuss with a doctor and strictly follow precautions.

Consult with a doctor to discuss the possibility of prophylactic medication during pregnancy, and adhere to personal protective measures closely.

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