Risk is present throughout the country, including urban areas, except areas specified, risk present at all altitudes:
The city of Phnom Penh is risk free. There is low risk of malaria transmission at Angkor Wat and in the city centre of Siem Reap. Take meticulous anti-mosquito bite measures if only travelling to these areas. However, if travelling throughout the rest of the country, take malaria suppressive medication.
Note: If travelling to the western provinces that report multidrug resistant malaria (see below), take atovaquone-proguanil or doxycycline. For all other malarious areas take any of the medications listed below.
High risk months for Malaria are: January to December
Malaria transmission vector(s): A.minimus, A.sundaicus
Incidence of Plasmodium falciparum Malaria: 60%
Of the five species of human malaria parasites, Plasmodium falciparum is the most dangerous. The remaining percentage represents malaria infections that may be caused by one or more of the following parasites: Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi.
Areas with drug resistant Malaria: The provinces of Siem Reap, Preah Vihear, Oddar Meancheay, Banteay Meanehey, Battambang, Pailin, Pursat, Kampat and Koh Kong report P. falciparum malaria resistance to chloroquine, mefloquine hydrochloride and sulfadoxine-pyrimethamine. The southern and western provinces also report resistance to artesunate, lumefantrine and piperaquine.
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.
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.
Brand names: Vibramycin and others; generics available.
TAKE 1 TABLET DAILY (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.
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.
MEFLOQUINE HYDROCHLORIDE IS NOT EFFECTIVE IN SOME AREAS OF THIS COUNTRY. SEE 'Areas with drug resistant Malaria' ABOVE FOR SPECIFIC LOCATIONS.