Madagascar

Recommended Vaccinations For Madagascar

For Most Travellers

Hepatitis A Vaccine

There is a significant risk of exposure to hepatitis A for this country, therefore, the vaccination is recommended.

Hepatitis B Vaccine

There is a significant risk of infection with hepatitis B for this country, therefore, the vaccination is recommended.

Polio Vaccine

Travellers who intend to visit this country for 4 weeks or more may be required to show proof of polio vaccination taken 4 weeks to 12 months prior to arrival in the country. Failure to produce this documentation may result in vaccination at the entry ports. Childhood vaccinations, including polio, should be up-to-date prior to travel.

For Some Travellers

Yellow Fever Vaccine

Travellers are not at risk for yellow fever for this country. However, a yellow fever vaccination certificate is required for travellers over 9 months of age arriving from countries with risk of yellow fever transmission and for travellers having transited more than 12 hours through an airport of a country with risk of yellow fever transmission.

Typhoid Fever Vaccine

There is a risk of exposure to typhoid fever in this country through consumption of unsafe food and water. Since exposure to unsafe sources is variable within this country, the vaccination against typhoid fever is generally recommended, especially when visiting smaller cities or rural areas, where food and water sources may be contaminated.

Measles, Mumps, Rubella (MMR) Vaccine

A dose of Measles-mumps-rubella (MMR) vaccine is recommended for all travellers over 6 months of age.

Rabies Vaccine

Vaccination against rabies is recommended for travellers involved in outdoor activities (e.g., campers, hikers, adventure travellers, and cavers) who may have direct contact with rabid dogs, bats, and other mammals. Those with occupational risks (such as veterinarians, wildlife professionals, researchers) and long-term travellers and expatriates are at higher risk and should be vaccinated.

Recommended Medications For Madagascar

For Some Travellers

Anti-malarial Drugs

All areas of Madagascar are at high risk for malaria. Recommended anti-malaria medication includes atovaquone- proguanil, doxycycline, or mefloquine. Anti-malaria drug resistance for chloroquine is present.

Diseases To Be Aware of for Madagascar

For Most Travellers

Dengue Fever

Dengue fever outbreaks have occurred in Madagascar.

Chikungunya Fever

Chikungunya is a viral disease that occurs in Madagascar. Outbreaks of this disease usually occur during the tropical rainy season, however, outbreaks can occur during the dry season as well.

Hepatitis A

There is a significant risk for hepatitis A virus exposure in Madagascar through contaminated food or water. Infection can still occur at tourist destinations and resorts.

Hepatitis B

There is a significant risk for acquiring hepatitis B in Madagascar.

For Some Travellers

West Nile Fever

The virus is transmitted to animals, birds and humans by mosquitoes. Symptoms include fever, headache, tiredness, body aches, nausea, and skin rash.

Sleeping Sickness (Type 1)

African trypanosomiasis occurs in this country. Travellers to urban areas are not at risk.

Hanta Virus

There is a risk of acquiring Hantavirus in this country through the consumption of food and water contaminated by an infected rodent or through rodent bites.

Leishmaniasis

There is a risk of acquiring Leishmaniasis in this country through sand fly bites, particularly between dusk to dawn. Adventure tourists, outdoor athletes, or humanitarian aid workers are at a higher risk.

Rift Valley Fever (RVF)

Commonly spread via contact with domesticated animals infected with the virus. These include cattle, buffalo, sheep, goats, and camels, among others.

Crimean-Congo Haemorrhagic Fever

There is a risk of Crimean-Congo Haemorrhagic fever in this country.

Measles

There is a risk of Measles in this country, especially in infants aged 6 to 11 months.

Polio

Vaccine-derived poliovirus type 1 (cVDPV2) was detected in this country, with the potential risk of global circulation. Unvaccinated or under-vaccinated travellers are at a higher risk if they come in direct contact with an infected person or through contaminated food and water, especially when visiting smaller cities, villages, or rural areas with poor hygiene standards.

Typhoid Fever

Unvaccinated people can become infected through contaminated food and water in Madagascar, especially when visiting smaller cities, villages, or rural areas where food and water sources may be contaminated.

Malaria

All areas are at high risk for malaria, especially coastal areas.

Yellow Fever

Travellers are not at risk for yellow fever for this country. However, a yellow fever vaccination certificate is required for travellers over 9 months of age arriving from countries with risk of yellow fever transmission and for travellers having transited more than 12 hours through an airport of a country with risk of yellow fever transmission.

Tuberculosis

Tuberculosis occurs in this country. Travellers to this country are at risk for tuberculosis if visiting sick friends or family, working in the health care field, or having close prolonged contact with the general population.

African Tick Bite Fever

This disease may occur in this country.

Plague

Plague continues to be a threat in Madagascar, particularly in the central highlands and in the provinces of Antananarivo, Antsiranana, Fianarantsoa, Mahajanga, and Toamasina. The disease usually occurs in rural areas, and urban outbreaks are rare. The risk to travellers is low unless they have contact with fleas, infected rodents, or suspected plague patients.

Rabies

Rabies occurs in this country. Travellers involved in outdoor activities (e.g., campers, hikers, adventure travellers, and cavers) may have direct contact with rabid dogs, bats, and other mammals. Those with occupational risks (such as veterinarians, wildlife professionals, researchers) and long-term travellers and expatriates are at higher risk.

Schistosomiasis

The parasite that causes schistosomiasis is found in Madagascar. It is acquired through contact with fresh water, such as swimming, bathing, or rafting. Well-chlorinated swimming pools and contact with saltwater in oceans or seas will not put travellers at risk for schistosomiasis.

Safety & Security in Madagascar

Personal Safety

Travellers to Madagascar should maintain an awareness of their personal security at all times due to political tensions in the country.

The crime rate is fairly high in Madagascar. Robberies, gang activity, kidnappings, and home invasions can occur and are often violent. Foreigners and employees of non-governmental organizations are sometimes targeted. Road travel can be dangerous. Armed attacks have occurred on main highways, particularly at night.

Travellers should avoid persons claiming to be “guides”, as they are generally criminals in disguise with intentions to assault or steal from travellers. Do not travel alone at night or on beaches in coastal tourist areas or any other isolated area.

Petty crime, such as purse snatching, pick-pocketing, and theft from vehicles is common. Travellers should avoid showing signs of affluence and ensure their belongings and documents are secure at all times. Do not leave your bags unattended.

Driving in Madagascar can be dangerous due to poor road conditions, poorly marked roads, poorly maintained vehicles, pedestrians and roaming animals. During the rainy season, road conditions deteriorate. While driving, keep the windows up and the doors locked. Armed attacks sometimes occur on highways, particularly at night. Taxis and public transportation are also targeted. Roadblocks also occur occasionally.

Exercise caution if travelling to national parks, as assaults are often reported in these isolated areas. Always travel to national parks with a group or a reputable guide.

Keep your passport with you at all times in case you are stopped and must show identification.

There are strict export laws in Madagascar. Seek local advise and permission if you would like to export items such as stones, jewels or sculptures.

Do no take photos of military or governmental installations. Do not dress in camouflage or military clothing.

Heavy rains and tropical cyclones can occur in Madagascar, especially between November-April. Flooding, landslides, major damage to infrastructure and disruption to travel plans may result. Monitor weather reports closely. If a natural disaster occurs, follow advice of local authorities.

LGBTI travellers should note that although same-sex sexual behaviours are not illegal, same-sex relations are not socially tolerated and LGBTI travellers are likely to face discrimination.

Extreme Violence

There have been reports of violent clashes and crimes, resulting in deaths, across all regions of Madagascar. Some regions include:
Northern Madagascar: in the beach and crowded areas of Nosy Be, Ankify Port and Ambanja
Western Madagascar: on National Routes around Besalampy, Morombe, Tsiroanomandidy and Maintirano
Southern Madagascar: in the Southern triangle between Ihosy, Toliara and Fort-Dauphin.
Although there have been no terrorist attacks in the recent past, the threat of terrorism cannot be ruled out.

Political Unrest

Demonstrations occur frequently and with little warning. Demonstrations, street disturbances, and political gatherings should be avoided as they can become violent with little warning.

Travellers should ensure they have supplies of food, water, fuel, money and medications in case of extreme civil unrest.

Presidential elections are scheduled to take place in November 2023. Politicians may engage in vigorous campaigning through demonstrations, rallies and protests. There may be a high risk of clashes between supporters of rival parties.

Areas To Avoid

Avoid travelling to Batterie beach, north of Toliara due to reports of violent assaults.

Avoid travelling to the Anosy region as there have been recent reports of armed attacks on villages in this region resulting in deaths and the displacement of hundreds of people.

Exercise extreme caution in and around Antananarivo due to a high rate of violence and crime.
Reconsider travel to the area in and around the city of Tsaratanana in the Betsiboka Region; the area along the road connecting the city of Tsiroanomandidy in the Bongolava Region with the coastal city of Maintirano in the Melaky Region; and the area in and around the city of Betroka in the Anosy Region, due to violent crime and banditry.