If you are going to live or work in sub-Saharan Africa, get the yellow fever vaccine and the International Certificate of Vaccination or Prophylaxis (the “yellow book”, 小黄本) before you leave, and plan how you will avoid malaria. One dose of yellow fever vaccine protects for life, and since 11 July 2016 the certificate is also valid for life, with no booster required [1]. For malaria, nothing replaces avoiding mosquito bites and getting tested as soon as you have a fever.
This page summarises public information from the World Health Organization (WHO) and official Chinese sources. It is general information, not medical advice. Ask an International Travel Healthcare Center or a travel clinic which vaccines and preventive medicines you need.
Yellow fever vaccine and the yellow book
Validity and when it takes effect
Under the amendment to Annex 7 of the International Health Regulations (2005), adopted by resolution WHA67.13, yellow fever certificates have been valid for life since 11 July 2016. This applies to certificates already issued. Countries may not reject a certificate because more than 10 years have passed, and may not require a booster [1]. The vaccine takes about 10 days to work, so get it at least 10 days before you travel [3]. WHO recommends vaccination for travellers aged 9 months and older going to at-risk areas. Infants under 9 months, pregnant or breastfeeding women and severely immunocompromised people need an individual assessment by a doctor [2].
Entry requirements by country
The table follows WHO’s International Travel and Health Annex 1 country list (published November 2022, revised January 2023; still the latest version WHO has published as of October 2026) [1]. “At-risk countries” are those WHO lists as having a risk of yellow fever transmission, such as Nigeria, Kenya, Ghana, Angola and DR Congo. Requirements can change at any time, so check with the embassy of your destination before you travel.
| Country | WHO yellow fever risk country | When proof of vaccination is required on arrival |
|---|---|---|
| South Africa | No | Travellers aged 1+ arriving from at-risk countries, including transits over 12 hours at an at-risk country’s airport |
| Nigeria | Yes | Travellers aged 9 months+ arriving from at-risk countries, including any airport transit there |
| Egypt | No | Travellers aged 9 months+ from at-risk countries, including transits over 12 hours |
| Kenya | Yes (parts) | Travellers aged 1+ from at-risk countries |
| Mauritius | Not on the WHO list | Not listed by WHO; check with the Mauritius embassy before travel |
| Tanzania | No | Travellers aged 1+ from at-risk countries, including transits over 12 hours |
| Zambia | No | Travellers aged 1+ from at-risk countries, including transits over 12 hours |
| Madagascar | No | Travellers aged 9 months+ from at-risk countries, including transits over 12 hours |
| Ethiopia | Yes (parts) | Travellers aged 9 months+ from at-risk countries, including transits over 12 hours |
| Ghana | Yes | All arriving travellers aged 9 months+ |
| Angola | Yes | All arriving travellers aged 9 months+ |
| DR Congo | Yes | All arriving travellers aged 9 months+ |
| China (returning) | No | Travellers aged 9 months+ from at-risk countries, including transits over 12 hours |
In practice, many Chinese in Africa move between several countries or change planes in hubs such as Nairobi, Addis Ababa or Lagos. Even if your destination has no yellow fever risk, you can be asked for the yellow book if you arrive from, or transit through, an at-risk country. China also requires the certificate from travellers arriving from at-risk countries [1]. If you are heading to Nigeria, Kenya or similar countries, keep the yellow book with your passport.
On the current situation, WHO reported on 24 June 2026 that Burkina Faso, the Central African Republic and Cameroon had 16 confirmed human cases between January and May 2026, with suspected cases under investigation in Angola, Côte d’Ivoire, Gabon, Ghana and Nigeria. WHO rated the risk in the African Region as moderate and does not recommend travel or trade restrictions [2].
Where to get vaccinated
In China, the yellow fever vaccine is given, and the certificate issued, by the International Travel Healthcare Centers (国际旅行卫生保健中心) run under the customs system. For example, the Shanghai International Travel Healthcare Center offers pre-travel consultations and vaccinations [3]. Most centres need an appointment and your passport; check with your local centre. If you are already in Africa, ask the host country’s health ministry for its designated yellow fever vaccination sites. The certificate must follow the IHR format and be issued by an approved centre [1].
Malaria: risk, prevention and treatment
How big is the risk
WHO estimates 282 million malaria cases and 610,000 deaths worldwide in 2024, with about 95% of both in the WHO African Region [4]. China was certified malaria-free by WHO in 2021, so cases in China are now mainly imported [3][5]. Among the eight focus countries:
- Egypt (2024) and Mauritius (1973) are certified malaria-free by WHO [5].
- In South Africa, malaria is endemic in Limpopo, Mpumalanga and KwaZulu-Natal (Department of Health, April 2025) [6]. Major cities such as Johannesburg and Cape Town are not among them.
- In Zambia, malaria occurs in almost all areas, with higher risk in lowlands and rural areas and peak transmission in the rainy season. The risk in Lusaka and other cities is lower but still present [7].
- In Tanzania, malaria is the leading infectious disease; in 2022 the country accounted for about 4.4% of global malaria deaths [8].
- Madagascar recorded about 1.35 million malaria cases from January to April 2025 [9].
- Nigeria and Kenya are also malaria-endemic countries in the WHO African Region; ask a travel clinic about the risk in your specific area.
For crime and other local risks, see country pages such as South Africa safety and Zambia safety.
Prevention
- Avoid bites: sleep under a mosquito net, screen doors and windows, wear long sleeves and trousers, and use a repellent containing DEET or similar ingredients on exposed skin [3][4][6].
- Preventive medicine: WHO advises seeing a doctor several weeks before departure about chemoprophylaxis. Some drugs must be started 2–3 weeks before travel and continued for 4 weeks after the last possible exposure [4]. Which drug and how to take it is for a doctor to decide based on your destination and health; this page gives no dosing.
- Sites and dormitories: remove standing water, especially in the rainy season [7].
Fever means test now
Early malaria symptoms are fever, headache and chills, usually starting 10–15 days after an infective bite. Untreated P. falciparum malaria can progress to severe illness and death within 24 hours [4]. If you get a fever in a malaria area or after returning to China, go to a proper hospital the same day for a blood smear or rapid test and tell the doctor where you have been. The MOFCOM guide for Zambia also warns: take medicine under a doctor’s guidance after diagnosis, and never self-medicate, let alone overdose, on suspicion alone [7].
WHO states that artemisinin-based combination therapies (ACTs) are the most effective treatment for P. falciparum malaria [4]. Two cautions. First, WHO has confirmed partial artemisinin resistance in Tanzania, Uganda, Rwanda and Eritrea, and suspects it in Zambia, Ethiopia and other countries [4]. Second, WHO estimates that at least 1 in 10 medicines in low- and middle-income countries are substandard or falsified [10]. Buy medicines from proper hospitals and pharmacies, not from unknown sellers.
Other infectious diseases to watch
- Cholera: from 1 January to 26 April 2026, 14 countries in the WHO African Region reported 45,250 cholera and acute watery diarrhoea cases, most in DR Congo, Mozambique and South Sudan; Angola, Nigeria, Zambia and Tanzania also reported cases [11]. The MOFCOM guide for Zambia advises Chinese citizens going there to take the cholera vaccine [7]. Drink only bottled or boiled water and avoid ice of unknown origin and raw seafood [3].
- Mpox: WHO declared on 5 September 2025 that mpox was no longer a public health emergency of international concern; its standing recommendations were extended to 20 August 2026 [12]. Some African countries still report cases, so follow local notices.
- Typhoid, hepatitis A, rabies and others: ask a travel clinic whether you need these based on your itinerary and work. There have also been warnings about plague and measles in Madagascar’s provinces [9].
Returning to China: declaration and screening
Since 1 November 2023, the General Administration of Customs no longer requires travellers to fill in the entry/exit health declaration card. However, anyone with symptoms of an infectious disease, such as fever, cough, difficulty breathing, vomiting, diarrhoea, rash or unexplained bleeding under the skin, or who has been diagnosed with one, must report to customs and cooperate with temperature checks, epidemiological questioning, medical screening and sampling [13]. The revised Frontier Health and Quarantine Law was adopted on 28 June 2024, and the new catalogues of diseases took effect on 1 January 2025: yellow fever, cholera and Ebola virus disease are quarantinable diseases, and mpox is a monitored disease [14].
If you develop a fever in the weeks after returning, see a doctor, say you have just come back from Africa, and ask for a malaria test [3][4].
Health insurance and medical evacuation
In many parts of Africa, care for serious illness is limited. When buying insurance, check that it covers local hospital treatment and emergency medical evacuation (to a neighbouring country or back to China), and that the country where you live is within the covered area. If your employer posted you, ask what cover the company already provides. For help with serious illness or accidents, contact the Chinese embassy or consulate; see consular protection and assistance.
References
- WHO: Countries with risk of yellow fever transmission and countries requiring yellow fever vaccination (International Travel and Health, Annex 1, 18 Nov 2022, revised 3 Jan 2023) (World Health Organization, 2022 (revised 2023))
- WHO Disease Outbreak News: Yellow fever – global situation (World Health Organization, 24 June 2026)
- 上海健康播报：出境旅行如何防黄热病、疟疾 (The Paper, 2 July 2026)
- WHO Fact sheet: Malaria (World Health Organization, 4 Dec 2025)
- WHO: Countries and territories certified malaria-free by WHO (World Health Organization, updated July 2025)
- Health Department calls for vigilance against malaria (SAnews (South African Government News Agency), April 2025)
- 对外投资合作国别（地区）指南：赞比亚（2025年版） (MOFCOM, 2025)
- 对外投资合作国别（地区）指南：坦桑尼亚（2025年版） (MOFCOM, 2025)
- 对外投资合作国别（地区）指南：马达加斯加（2025年版） (MOFCOM, 2025)
- WHO Fact sheet: Substandard and falsified medical products (World Health Organization, Dec 2024)
- WHO: Multi-country outbreak of cholera, epidemiological update #37 (World Health Organization, 29 May 2026)
- WHO: Fifth meeting of the IHR Emergency Committee regarding the upsurge of mpox 2024 (World Health Organization, Oct 2025)
- 海关总署：出入境人员免于填报健康申明卡 (General Administration of Customs (via Beijing Foreign Affairs Office), Nov 2023)
- 筑牢口岸检疫防线 检疫和监测传染病目录将施行 (Xinhua, 31 Dec 2024)