World Country Guide

1
A yellow fever certificate is required from travellers over one year of age.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry to Chad. However, cholera is a serious risk in this country and precautions are essential. A current Cholera outbreak is affecting N'Djamna, Chari Baguirmi, Karem and Lac. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness. See the Health appendix for more information.

3
Immunisations or boosters for typhoid and polio are recommended.

4
Risk of malaria (and of other insect-borne diseases) exists all year throughout the country. The malignant falciparum form is prevalent. Resistance to chloroquine is reported. The recommended prophylaxis is mefloquine.

Food & Drink
All water should be regarded as being potentially contaminated. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid all dairy products. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Bilharzia (schistosomiasis) is present, but only in the south and southeast of the country. Avoid swimming and paddling in fresh water; swimming pools which are well chlorinated and maintained are safe. River blindness (onchocerciasis) and sleeping sickness (trypanosomiasis) are also prevalent. Meningococcal meningitis occurs, particularly in the savannah areas during the dry season (November to May). Immunisation is compulsory. A recent outbreak in the Iriba district resulted in 15 cases and four deaths - above the epidemic threshold. Immunisation against diphtheria and hepatitis B should be considered for longer visits. Hepatitis A and E are widespread in the region (especially in the north and east of Chad). Between June and August 2004 there were 672 cases/21 deaths of acute jaundice syndrome (AJS) in Coz Amer, where lies a camp of Sudanese refugees - and the Hepatitis E virus has been confirmed. HIV/AIDS is prevalent.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Health care
Medical facilities are poor, particularly in the north, and health insurance (to include emergency repatriation) is essential.