Malaria in Tanzania — what you really need to know before your safari

Malaria in Tanzania: the real risk

Let me start with something that irritates me about some travel blogs: they exaggerate the malaria risk so much that people abandon the idea of visiting Tanzania. That's unnecessary.

Malaria is present in Tanzania. It's a serious disease that deserves attention. But with the right precautions and medication, the risk for the average safari visitor is very manageable.

Here's what you need to know.

Where the risk is highest

The malaria parasite is transmitted by the Anopheles mosquito, which bites at night. Risk varies significantly by region:

High risk: coastal areas (Zanzibar, Dar es Salaam), lower-lying park areas (Nyerere, Ruaha, Selous region), lower-lying parts of the Serengeti.

Lower risk: higher-altitude areas like the Ngorongoro Highlands (>2,000m), Arusha itself (1,400m). Colder climate = fewer mosquitoes. But "lower risk" doesn't mean "no risk."

Moderate risk: most national parks where safaris take place.

Zanzibar has a clearly elevated risk compared to the mountain areas.

The three main options for prophylaxis

Malarone (atovaquone/proguanil) is the most popular choice for Tanzania travellers. One tablet per day, starting one to two days before departure, stopping seven days after return. Advantages: few side effects for most people, flexible for shorter trips. Disadvantage: relatively expensive (€2-3 per tablet without insurance).

Doxycycline is the cheapest alternative. One tablet per day, starting one day before departure, stopping four weeks after return. Advantages: low cost (< €0.20 per tablet), also effective against other infections. Disadvantages: increased sun sensitivity (strict SPF50+ use required), stomach issues in some users, not ideal around pregnancy.

Lariam (mefloquine) is still prescribed but less popular due to possible neuropsychiatric side effects (vivid dreams, mood changes). Weekly tablet, starting two to three weeks before departure. Excellent for some; problematic for others. Always discuss with a doctor first.

Which is best for a Tanzania safari?

For most travellers going to Tanzania for two to four weeks, I recommend Malarone. It's effective, has few side effects, and combines well with the normal rhythms of a safari.

For travellers going longer (six weeks or more) or with a smaller budget, Doxycycline is a good option — provided you're willing to use sunscreen consistently.

Always discuss this with your GP or a travel medicine specialist. They know your medical history; I don't.

Mosquito prevention: at least as important as medication

Pills are not a guarantee. The mosquitoes simply shouldn't bite you.

Use DEET-based mosquito repellent (at least 20-30%) on bare skin. Every evening, without exception.

Wear covered clothing after sunset. Long sleeves, long trousers, closed shoes. In the parks, this is already recommended for cool mornings anyway.

Check whether your room or tent has a mosquito net and that it has no holes. Well-run camps in Tanzania always take care of this.

Sleep with the air conditioning on or a fan on the lowest setting — mosquitoes avoid air movement.

Symptoms: know what you're looking for

Fever, chills, headache, and joint pain occurring one to four weeks after visiting a malaria-risk area? Go to a doctor immediately and mention that you've been to Tanzania.

Early treatment is crucial. Malaria is treatable if recognised in time.

Pregnancy and children

Pregnant women have limited medication options (Malarone is contraindicated; some doctors don't prescribe Doxycycline at certain stages). Discuss this thoroughly with a gynaecologist and travel medicine specialist.

For children, weight-based doses of Malarone are available. Have this prescribed by a paediatrician or travel medicine specialist.

The bottom line

Malaria is not a reason to avoid Tanzania. It's a reason to prepare properly. Good medication, good mosquito prevention, and awareness of symptoms is all you need.

Millions of people visit Tanzania safely every year. With a little preparation, you'll be one of them.