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Directory of Cities, Towns, and Regions in China of China HYPERLINK "" with MalariaEstimated relative risk of Malaria for US Travelers2Drug Resistance3Malaria Species4Recommended Chemoprophlaxis5Helpful links for Select CountriesIndiaAll areas throughout country including cities of Bombay (Mumbai) and Delhi, except none in areas above 2,000 m (6,562 ft) in Himachal Pradesh, Jammu and Kashmir, and Sikkim.ModerateChloroquineP. vivax 50%P. falciparum >40%P. malariae and P. ovale rareAtovaquone-proguanil, doxycycline, or mefloquineAltitude information and to determine if city is within a certain provinceMap of provinces in IndiaChinaPresent year round in rural parts of Anhui, Guizhou, Hainan, Henan, Hubei, and Yunnan Provinces.Rare cases occur in other rural parts of the county below 1,500 m (4,921 ft) May–December. None in urban areas.Some major river cruises may go through malaria endemic areas in Anhui and Hubei Provinces.LowChloroquineMefloquinePrimarily P. vivaxP. falciparum in select locationsAlong China-Burma (Myanmar) border in the western part of Yunnan province: Atovaquone-proguanil or doxycyclineHainan and other parts of Yunnan province: Atovaquone-proguanil, doxycycline, or mefloquineAnhui, Guizhou, Henan, and Hubei provinces: Atovaquone-proguanil, chloroquine, doxycyline, mefloquine, or primaquine7All other areas with malaria including river cruises that pass through malaria-endemic provinces: Mosquito avoidance only.Altitude information and to determine if a city is within a certain provinceMap of ChinaMap of India , Directory of Cities, Towns, and Regions in India India is a federation composed of 29 states and 7 union territories.[176] All states, as well as the union territories of Puducherry and the National Capital Territory of Delhi, have elected legislatures and governments, both patterned on the Westminster model. The remaining five union territories are directly ruled by the centre through appointed administrators. In 1956, under the States Reorganisation Act, states were reorganised on a linguistic basis.[177] Since then, their structure has remained largely unchanged. Each state or union territory is further divided into administrative districts. The districts in turn are further divided into tehsils and ultimately into villages.012382500A clickable map of the 29 states and 7 union territories of IndiaMain article: Administrative divisions of IndiaStatesAndhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJammu and KashmirJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalUnion territoriesAndaman and Nicobar IslandsChandigarhDadra and Nagar HaveliDaman and DiuLakshadweepNational Capital Territory of DelhiPuducherryChoosing a Drug to Prevent MalariaConsiderations when choosing a drug for malaria prophylaxis:Recommendations for drugs to prevent malaria differ by country of travel and can be found in the country-specific tables of the Yellow Book. Recommended drugs for each country are listed in alphabetical order and have comparable efficacy in that country.No antimalarial drug is 100% protective and must be combined with the use of personal protective measures, (i.e., insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting or using an insecticide-treated bednet).For all medicines, also consider the possibility of drug-drug interactions with other medicines that the person might be taking as well as other medical contraindications, such as drug allergies.When several different drugs are recommended for an area, the following table might help in the decision process.DrugReasons that might make you consider using this drugReasons that might make you avoid using this drugAtovaquone/Proguanil (Malarone)Good for last-minute travelers because the drug is started 1-2 days before traveling to an area where malaria transmission occursSome people prefer to take a daily medicineGood choice for shorter trips because you only have to take the medicine for 7 days after traveling rather than 4 weeksVery well tolerated medicine – side effects uncommonPediatric tablets are available and may be more convenientCannot be used by women who are pregnant or breastfeeding a child less than 5 kgCannot be taken by people with severe renal impairmentTends to be more expensive than some of the other options (especially for trips of long duration)Some people (including children) would rather not take a medicine every dayChloroquineSome people would rather take medicine weeklyGood choice for long trips because it is taken only weeklySome people are already taking hydroxychloroquine chronically for rheumatologic conditions. In those instances, they may not have to take an additional medicineCan be used in all trimesters of pregnancyCannot be used in areas with chloroquine or mefloquine resistanceMay exacerbate psoriasisSome people would rather not take a weekly medicationFor trips of short duration, some people would rather not take medication for 4 weeks after travelNot a good choice for last-minute travelers because drug needs to be started 1-2 weeks prior to travelDoxycyclineSome people prefer to take a daily medicineGood for last-minute travelers because the drug is started 1-2 days before traveling to an area where malaria transmission occursTends to be the least expensive antimalarialSome people are already taking doxycycline chronically for prevention of acne. In those instances, they do not have to take an additional medicineDoxycycline also can prevent some additional infections (e.g., Rickettsiae and leptospirosis) and so it may be preferred by people planning to do lots of hiking, camping, and wading and swimming in fresh waterCannot be used by pregnant women and children <8 years oldSome people would rather not take a medicine every dayFor trips of short duration, some people would rather not take medication for 4 weeks after travelWomen prone to getting vaginal yeast infections when taking antibiotics may prefer taking a different medicinePersons planning on considerable sun exposure may want to avoid the increased risk of sun sensitivitySome people are concerned about the potential of getting an upset stomach from doxycyclineMefloquine(Lariam)Some people would rather take medicine weeklyGood choice for long trips because it is taken only weeklyCan be used during pregnancyCannot be used in areas with mefloquine resistanceCannot be used in patients with certain psychiatric conditionsCannot be used in patients with a seizure disorderNot recommended for persons with cardiac conduction abnormalitiesNot a good choice for last-minute travelers because drug needs to be started at least 2 weeks prior to travelSome people would rather not take a weekly medicationFor trips of short duration, some people would rather not take medication for 4 weeks after travelPrimaquineIt is the most effective medicine for preventing P. vivax and so it is a good choice for travel to places with > 90% P. vivaxGood choice for shorter trips because you only have to take the medicine for 7 days after traveling rather than 4 weeksGood for last-minute travelers because the drug is started 1-2 days before traveling to an area where malaria transmission occursSome people prefer to take a daily medicineCannot be used in patients with glucose-6-phosphatase dehydrogenase (G6PD) deficiencyCannot be used in patients who have not been tested for G6PD deficiencyThere are costs and delays associated with getting a G6PD test done; however, it only has to be done once. Once a normal G6PD level is verified and documented, the test does not have to be repeated the next time primaquine is consideredCannot be used by pregnant womenCannot be used by women who are breastfeeding unless the infant has also been tested for G6PD deficiencySome people (including children) would rather not take a medicine every daySome people are concerned about the potential of getting an upset stomach from primaquine ................
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