Health & Vaccinations

Vaccinations

The following vaccinations are recommended for Madagascar:

Vaccination	Status
Hepatitis A	Strongly recommended
Typhoid	Recommended for longer stays
Hepatitis B	Recommended
Rabies	Recommended for animal exposure (rainforest tours)
Yellow fever	Mandatory only when entering from a yellow fever area
Tetanus/Diphtheria/Polio	Get a booster

Consult a tropical medicine institute 6–8 weeks before departure for personalized advice.

Malaria

Madagascar has a year-round malaria risk — especially on the coast and in rainforest areas. The highlands (Tana, Antsirabe) have a lower risk, but not zero. Malaria prophylaxis (Malarone or Doxycycline) is strongly recommended. Additionally:

• Wear long clothing at dusk and night
• Use insect repellent with DEET (30%+) on exposed skin
• Sleep under an impregnated mosquito net (good accommodations provide one)

Further Health Advice

• Drinking water: Drink ONLY bottled water. No tap water, no ice in drinks (except in upscale hotels/restaurants). Brush teeth with bottled water.
• Gastrointestinal issues: The most common illness among travelers. Wash hands, eat only peeled fruit, prefer cooked foods. Have Imodium and electrolyte powder on hand.
• Schistosomiasis: Do not swim in freshwater (lakes, rivers) — the parasites are invisible and dangerous. It's safe in the sea.
• Plague: Yes, the plague still exists — in rural highland areas. The risk for tourists is minimal but real. Avoid contact with rats, seek medical attention immediately for unexplained fever.
• Medical care: In Tana, there are some private clinics at an acceptable level (Clinique des Soeurs, Espace Médical). Outside the capital, care is rudimentary. International travel health insurance with repatriation is absolutely essential!