Health
Use bottled/treated water and careful food hygiene. Mosquito-borne illness is a key risk: malaria occurs in most areas except rare transmission in Antananarivo; dengue/chikungunya also occur. Avoid freshwater swimming because schistosomiasis is present. Use bite protection, sun/heat precautions, and care around animals/rodents; highland treks are usually moderate altitude but can be strenuous.
Vaccinations
Consult a doctor or travel clinic at least 4 weeks before travel. Be up to date on routine vaccines, including MMR, polio, flu, varicella, Tdap/Td and COVID-19. CDC commonly recommends hepatitis A, hepatitis B and typhoid for Madagascar; discuss rabies for rural/animal exposure or limited access to care, and malaria prevention for most areas. Yellow fever vaccine is not recommended and is not required from the U.S.; a certificate is required for travelers age 9 months+ arriving from or transiting over 12 hours in a yellow-fever-risk country.
eSIM / connectivity
eSIM is available but should not be assumed everywhere. Orange Madagascar lists eSIM activation through Orange Shop/So Smart, and Yas Madagascar offers eSIM plus a tourist prepaid option sold at selected Yas shops, including Ivato airport and tourist destinations. Airtel is also a major local mobile operator for prepaid/4G SIM service; verify current eSIM availability before relying on it. Bring an unlocked, eSIM-compatible phone and expect ID registration.
Health/vaccine info is reference only, not medical advice — consult a doctor or travel clinic; defer to CDC/WHO and official sources (as of 2026-06-20).