Go to your doctor, and tell him/her that your going to Latin America, and they’ll almost certainly tell you you “must” take malaria pills, which are very expensive. Very often, indeed for most holiday makers to Latin America, you don’t need malaria pills. A small percentage of people can have some extremely averse reactions to malaria pills - if you don’t need to take them, then don’t. And NEVER take Larium, not matter what your doctor says - I know plenty of people who’ve hallucinated for this malaria pill, and heard of plenty of other stories of severe psychological illness caused by that drug. Here I’ll take a look at when / where exactly you need to take malaria pills in Latin America. I’ll mention each country as we travel South through Latin America:
Mexico - the vast majority of Mexico is malaria free. One is advised to take pills if visiting inland areas of Southernmost Mexico, including most places South and East from Oaxaca, with the exception of the Pacific Coast, where it’s not necessary.
Belize - malaria is present everywhere.
Guatemala - malaria is present throughout the country, with the exception of certain highland regions, including that of Guatemala City and Antigua. Almost everyone would be advised to take pills if visiting Guatemala.
El Salvador - most of the country is malaria free, with the exception of border areas (i.e close to the Honduran and Guatemalan borders).
Honduras - malaria is prevalent everywhere.
Nicaragua - almost the entire country has substantial risk, with the exception of the Southern Pacific coast, and the region around Ocotal to the North. Almost everyone will needs malaria pills if visiting Nicaragua.
Costa Rica - there’s next to no risk throughout the country (San Jose, the Pacific Coast and Tortuguero included). There only malaria regions in Costa Rica is in the South Eastern (Caribbean) section of the country around Puerto Limon - and most tourists don’t go anywhere near this region.
Panama - essentially there’s only malaria on the Caribbean coast (eg. Bocas del Toro & San Blas Islands), in addition to the rainforest regions of the East - the Darien province. In Panama City, the highlands and almost all the Pacific Coast, there’s minimal risk.
Colombia - malaria pills are rarely required by visitors, and the disease is only found in the (remote) rainforest regions of the Pacific Coast (Choco province & Nuqui & Bahia Solano), the Amazon (Leticia) and rainforest regions to the South and East, as well as most of Southern Colombia (eg. around Popayan & San Agustin). Cartagena, Cali, Bogota, Medellin and most of the Caribbean coast have little to no risk.
Venezuela - malaria is a risk in Eastern and Southern Venezuela, including everywhere East and South of Ciudad Bolivar - so that includes Canaima, Angel Falls and the Orinoco Delta. Margarita island is not a malaria zone.
Guyana, Suriname and French Guiana - generally speaking, the coastal regions are malaria free, while the disease is prevalent throughout the rainforested interior, though there are a few excepions where malaria is present on the coast.
Ecuador - malaria is only found in the low lying regions, including the Amazon region to the East, Esmeraldas province to the very North (including Atacames), just North of Quito (eg. Otavalo) and the very south of the country (around Loja). The vast majority of regions have next to no risk, including Quito, Cuenca and the Galapagos Islands.
Peru - there is a risk in most of low lying Northern and much of Central Peru, including the malaria zones of the Amazon region (Iquitos and around), the North Western coastal region from Chiclayo to Tumbes and Puerto Maldonado to the East of Peru. There is very little risk anywhere South of Lima - Lima, Arequipa, Lake Titicaca, Nazca and Cuzco are all very low risk regions. Machu Picchu is close to malaria regions, but taking tablets is not normally necessary.
Bolivia - there is no malaria present in most of this highland country, with the exception of the Northern border region with Brazil, and the South Eastern region bordering Paraguay and Argentina.
Brazil - Malaria is only prevalent in the Amazon region, in addition to Iguassu Falls. The whole of the coast from Belem Southwards, including Rio and Salvador, plus Brasilia, the Pantanal (except the Northernmost sections bordering Bolivia), Sao Paulo and all of Southern Brazil have minimal risk.
Paraguay - malaria is only a real risk in a small Eastern region around Ciudad del Este.
Argentina - as a more temperate country, almost all of Argentina is malaria free. The only sections are the area around Iguassu Falls in the North East, and (apparently) a small part of the border region with Bolivia, North of Salta (though not including Salta itself).
Chile - malaria is not present.
All the above advice comes from the NHS’s (UK’s National Health Service) Fit For Travel website, where malaria maps can be found on all these destinations in Latin America. I cannot vouch for it’s accuracy, though I do have personal confidence in it, but I take no responsibility with regards to the information provided on this page being accurate. Check with a doctor if you’re concerned.