Indonesia Malaria General Malaria Information: Approximately Equal Between P

Indonesia Malaria General malaria information: approximately equal between P. falciparum and P. vivax, with P. knowlesi reported on Kalimantan Issues to Consider (Borneo) Island. Transmission occurs throughout the year. Extremely high transmission occurs in the provinces of East Nusa Tenggara (Flores Island) [18], Maluku [19], Papua [20], West Papua [21], and North Maluku [22]. Factors favoring chemoprophylaxis • Adventure travel Location-specific recommendations: • Risk-averse and vulnerable travelers Chemoprophylaxis is recommended for all travelers: altitudes below 2,000 m (6,600 ft) on all islands east of Bali, including • Areas subject to infrequent epidemics Lombok Island but excluding the Gili Islands; most regencies of Kalimantan (Borneo) and Sumatra, including Batam Island and • Immigrants visiting friends and relatives most areas of Bintan Island; limited foci in rural areas of Java that are rarely visited by tourists; all cities and towns within these • Flexible itineraries areas except Banda Aceh, Pekanbaru, Palembang, and the central urban areas of Balikpapan and Bandjermasin. • Travel longer than 1 month Chemoprophylaxis is recommended for certain travelers (see Issues to Consider box): altitudes below 2,000 m in certain • Unreliable medical expertise and/or regencies of Sumatra, Java, Kalimantan (Borneo) and Sulawesi; all cities and towns within these areas except the central treatment drugs at destination urban areas of Samarinda and Mataram. Factors against chemoprophylaxis Insect precautions only are recommended (negligible transmission is reported): rural areas below 2,000 m in certain regencies • Air-conditioned hotels only of Sumatra and Java; typical tourist resort locations on northern Bintan Island; the central urban areas of Balikpapan, • Urban areas only Samarinda, Bandjermasin, and Mataram. • Non-transmission season No preventive measures are necessary (no evidence of transmission exists): urban areas and typical resort locations on Java • Minimal nighttime exposure and Bali; the Gili Islands; the cities of Jakarta, Yogyakarta, Banda Aceh, Medan, Pekanbaru, Padang, and Palembang; the • Travel shorter than 3 days Thousand Islands; altitudes above 2,000 m; all other areas not mentioned above. For more information, see Technical Explanation of Malaria Mapping. Preventive measures: Evening and nighttime insect precautions are essential in areas with any level of transmission. Both P. falciparum and P. vivax are uniformly chloroquine- resistant. Atovaquone-proguanil (Malarone or generic), doxycycline, and mefloquine are protective in this country. Effective antimalarial drugs may not be available in this country. Travelers staying longer than 3 weeks should consider carrying a treatment dose of co-artemether or atovaquone-proguanil in case their protective medicines fail (treatment dose should be administered under the supervision of a qualified local health care provider). For travel to the provinces of East Nusa Tenggara [18], Maluku [19], Papua [20], West Papua [21], or North Maluku [22], presumptive antirelapse therapy (PART) with primaquine is recommended for all travelers at the end of their exposure. Relapses of P. vivax malaria may occur weeks or months after departure even in those who have adhered to all recommended measures and in those who experienced no signs or symptoms of initial malaria infection. G6PD testing is required prior to primaquine use.

98°E 106°E 114°E 122°E 130°E 138°E

Banda Bintan Aceh Strait THAILAND Batam Is. Resorts ! ! of South SINGAPORE ! ! ! ! ! ! ! ! ! ! ! ! ! ! #A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Bintan Is. ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Malacca China Batam ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! PHILIPPINES 5°N BRUNEI ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! MALAYSIA Sea " ! ! ! ! ! ! ! ! ! Tanjung ! ! ! ! ! ! ! ! 1! ! ! ! ! ! ! ! ! ! ! !Medan Gunung ! ! ! ! ! ! ! ! ! ! ! ! A" Pinang ! ! ! ! ! ! ! ! ! #A! ! ! Leuser ! ! ! ! ! ! ! ! ! ! ! ! ! ! Celebes N.P. ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 33 ! ! ! ! ! ! ! Sea ! ! ! ! ! ! ! 24 ! ! ! ! ! ! ! ! ! ! ! ! ! ! SINGAPORE MALAYSIA 2 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Manado 0 20 40 80 ! ! ! ! ! ! ! ! ! !Batam ! ! ! ! ! ! ! ! ! ! ! ! ! " KM ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Is. ! ! ! Bintan Is. 30 Pe! !k!a! n! b! !a! !r!u! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! (see inset) ! ! ! ! ! ! ! ! ! ! ! ! ! ! #A! ! ! ! ! ! ! ! ! ! AN ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! KALIM TAN ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! " 3! ! ! ! ! S 6 ! ! 4 32 Samarinda "G 23 #A U Pontianak M Balikpapan "G 22 Padang A 5"Jambi S 21 ! ! ! T 26 U ! ! ! R ! ! ! ! ! ! ! ! ! ! 10 31 L A ! ! ! ! ! ! ! ! ! ! A 25 ! ! ! ! ! ! ! ! ! ! " Kerinci ! ! ! ! ! ! ! ! ! ! W #A! ! ! ! ! ! ! ! ! ! 20 Jayapura 3°S Seblat N.P. ! ! ! ! ! ! ! ! ! ! E 8 ! ! ! ! ! ! ! ! ! ! "G 7 ! ! ! P! !a! !le! !m! bang 29 S " ! ! ! ! ! ! ! ! ! ! " ! ! ! ! ! ! ! ! ! ! Java Bandjermasin Tana I ! ! ! ! ! ! ! ! ! ! PAPU Bengkulu ! ! ! ! ! ! ! ! !T!housand Toraja Ambon A ! ! ! ! ! Sea ! ! ! ! ! ! ! ! ! ! Islands 27 28 9 ! ! ! ! ! Banda ! ! ! ! ! " Lorentz ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Sea N.P. ! ! ! ! ! ! ! J! !a! !k! !a! rta ! ! ! ! ! ! ! ! ! Makassar ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 19 Bukit Barisan ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 13 ! ! ! Selatan N.P. ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! B! !orobud! !u!r! ! ! ! ! ! ! ! ! ! 11 ! ! ! ! ! ! ! ^_! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !1! !2! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !#A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !#A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Bandu! n! !g! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! JA! ! V! ! A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !1! !5! ! ! ! ! S! ! u! !r!a! b! !aya ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Komodo Flores Is. 0 20 40 80 ! ! ! ! ! ! ! ! ! ! ! !#A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 16 17 KM ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! N.P. ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Yogyakarta ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! #A! ! ! ! "G ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Gili Is. Pacific ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 14 Denpasar Mataram ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! TIMOR-LESTE ! ! ! ! ! ! !B! A! ! L! !I! ! ! ! ! ! ! ! ! ! ! !Senggigi 18 Ocean ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Bali Is. " PAPUA ! ! ! ! ! ! ! ! ! ! ! ! U! b! u! !d! ! ! ! ! ! (see inset) Kupang NEW 11°S ! ! ! ! !"A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !Mataram"G Timor GUINEA Denpa! s!a! r! ! ! ! ! ! ! ! ! ! Indian ! ! ! !"A! ! ! ! ! ! ! ! ! Sea ! ! ! ! ! ! ! ! ! ! ! ! ! Ocean ! ! ! ! ! ! ! ! ! ! ! ! ! Kuta ! ! ! ! ! N! !u!sa! ! ! ! !Nusa LOMBOK ! ! ! ! ! !D! u!a! ! ! P! e!nida Is. AUSTRALIA Place of interest 0 250 500 1,000 1,500 2,000 KM Administrative boundary

NUMBERED PROVINCES 1 - Aceh 6 - Riau Islands 11 - Banten 16 - Bali 21 - West Papua 26 - West Sulawesi 31 - Central Kalimantan 2 - North Sumatra 7 - South Sumatra 12 - West Java 17 - West Nusa Tenggara 22 - North Maluku 27 - South Sulawesi 32 - West Kalimantan 3 - West Sumatra 8 - Bengkulu 13 - Central Java 18 - East Nusa Tenggara 23 - Gorontalo 28 - Southeast Sulawesi 33 - North Kalimantan 4 - Riau 9 - Lampung 14 - Yogyakarta 19 - Maluku 24 - North Sulawesi 29 - South Kalimantan 5 - Jambi 10 - Bangka Belitung Islands 15 - East Java 20 - Papua 25 - Central Sulawesi 30 - East Kalimantan

KEY for Location-Specific Recommendations — Evening and nighttime insect precautions are essential in areas with any level of transmission. Chemoprophylaxis is recommended for all travelers.* " City where preventive recommendations are the same as the surrounding region.

Chemoprophylaxis is recommended for certain travelers; see Issues to Consider box. City where insect precautions only are recommended in the central urban area *; at city outskirts G preventive recommendations are the same as the surrounding region. Insect precautions only are recommended * (negligible transmission is reported). A City where no preventive measures are necessary (no evidence of malaria transmission exists). No preventive measures are necessary (no evidence of malaria transmission exists). _ National capital (no preventive measures are necessary). * Exceptions may apply. For more information, see Technical Explanation of Malaria Mapping.