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

Hepatitis B

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

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.

For Some Travellers

Malaria

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

Crimean-Congo Haemorrhagic Fever

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

Sleeping Sickness (Type 1)

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

Measles

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

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.

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.

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.

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

Violent crime poses serious risks across Madagascar. Armed gangs operate throughout the country and commit home invasions, carjackings, armed robberies, and kidnappings. Foreign nationals have been targeted in both urban and rural areas. Petty crime such as pickpocketing, bag snatching, and theft is common, especially in Antananarivo and tourist areas. Thieves often target vehicles stuck in traffic, smashing windows to steal phones and valuables. Criminals have become bolder in recent years, committing offences in areas previously considered safe and well traveled. Robbery and violent assault occur even during daylight hours, particularly on isolated beaches and in coastal areas. Some attackers pose as tour guides to gain access to victims. Armed robberies happen frequently on main roads, especially after dark and outside major towns. The Dahalo, criminal gangs originally focused on cattle rustling, increasingly clash with security forces in southern and western regions. Kidnapping for ransom has increased, primarily targeting wealthy Malagasy nationals and the Indo-Pakistani community, though expatriates have been victims. Traffic accidents can quickly draw large and sometimes violent crowds. Mob justice incidents have occurred when communities take law enforcement into their own hands due to frustration with police response times and limited resources.

Extreme Violence

Madagascar has no recent history of terrorism, though attacks cannot be ruled out. The primary extreme violence concern involves the Dahalo, armed criminal gangs originally focused on cattle rustling who are increasingly clashing with security forces. These confrontations happen mainly in areas south and west of the capital. Between January and September 2023, media reported at least 200 deaths during security force operations. Violent incidents involving cattle rustlers in southern Madagascar have resulted in fatalities, though tourists have not been specifically targeted. In 2021, a large scale attack on three villages in Midongy District resulted in the deaths of 17 civilians and two military officers. Madagascar’s armed forces are active in southern regions. Foreigners are not typically targets of these violent confrontations, but the presence of armed groups and military operations in certain regions creates an unstable security environment.

Political Unrest

Since September 25, 2025, violent demonstrations have erupted across Madagascar, focused in Antananarivo and several major cities. The protests were triggered by chronic power outages, water shortages, and systemic corruption. At least 22 people have been killed and more than 100 injured according to UN figures. Violent incidents include shootings, looting, vandalism, and destruction of property. Homes of politicians have been targeted. Dusk to dawn curfews have been imposed in Antananarivo and most major cities. Antananarivo Ivato International Airport has closed and reopened multiple times with several flight cancellations. On September 29, President Rajoelina dissolved the government in response to the unrest, and on October 6 appointed military general Ruphin Zafisambo as prime minister. On October 11, an elite military unit that installed the president in 2009 joined protesters in what authorities described as an attempted coup. The movement, organized by Gen Z Madagascar using social media coordination, demands the president’s resignation and institutional reform. Demonstrations are frequent in Madagascar and can turn violent without warning. Police responses to protests often involve tear gas, rubber bullets, and can quickly become violent. Political unrest increases during election periods. The 2023 presidential election was marked by restrictions on opposition rallies, violent dispersal of protests, and widespread boycotts by opposition candidates. Madagascar experienced a coup in 2009 followed by years of political instability.

Areas To Avoid

The southern districts of Toliara and Fianarantsoa face multiple challenges including violent crime, drought, food insecurity, water scarcity, and poor infrastructure. Batterie Beach has strict local customs and has seen violent and fatal attacks on foreigners in recent years. Armed gangs attack vehicles between Antananarivo and Toliara. The road between Tsiroanomandidy and Maintirano is hazardous with violent criminal activity. The area around Betroka is dangerous. The Tsiribihina River in western Madagascar has experienced armed robberies against tourist boats. The popular tourist island of Nosy Be and the city of Antsohihy have experienced high rates of robberies and violence against foreigners, including attacks in daytime and crowded areas. Areas north of Fort Dauphin and along the west coast between Belo Sur Tsiribihina and Toliara involve armed forces due to violent incidents. In Antananarivo, specific neighborhoods with higher theft rates include Tsimbazaza near the Zoo and Botanical Garden, Isotry Market, Andohalo, Ambohijatovo, and Ivandry. The main hubs of Rova Avenue de l’Independence, Analakely Market, and Cafe de La Gare are particularly dangerous for tourists. Avoid these areas after dark. Remote beaches should be visited with local guides or experienced tour operators as opportunistic attacks have occurred. National parks require mandatory local guides, which provides some security, but visitors should remain vigilant as gangs have targeted tourists in these areas.