Malaria is a risk throughout the year and is highest on the
coast of Madagascar. Cases of chikungunya fever were reported in
February 2010 and are transmitted by mosquitoes; precautionary
measures against being bitten should be taken at all times. While
AIDS has not reached the levels of other sub-saharan countries,
protection should be used at all times. All travellers coming from
a country with yellow fever require inoculation against the
disease. Other risks include bilharzia, tuberculosis and rabies.
Tap water should not be drunk unless it has been boiled or
chemically treated. Medical facilities are limited, and outside of
the capital medical care may be difficult to find. Limited French
medications are available in Tana, however it is advisable to bring
along a medical kit for private use. Comprehensive medical
insurance is advised.