Risks of malaria exist at altitudes lower than 5000 feet (1500 meters). Travelers visiting Quito, the Andes Mountains, as well as Guayaquil and the Galápagos Islands surely won’t need any vaccination (prophylaxis). Although there are cases of malaria in Ecuador, they are restricted to remote areas of the Amazon usually not visited by tourists, and are part of certain Indian communities.

The best drug depends on your itinerary and on a number of personal factors that should be discussed between you and your healthcare provider. Malaria pills are a pretty strong medicine and you should be aware of its side effects, which can vary in intensity from person to person. You will have to start the treatment a week or two before going on vacation, depending on the medicine, and will continue for some time after coming back from your trip (usually from two weeks up to a month).

Personal protective measures are extremely important since mosquitoes cannot be avoided. Travelers to areas where insects that transmit diseases may be present can help minimize their risk by following certain precautions.
- If you are not sleeping in a sealed, air-conditioned room, use a bed net, preferably impregnated with insect repellent, with edges tucked under the mattress. Mosquitoes that transmit malaria are usually night biters.
- Apply insect repellent to exposed skin, avoiding eyes, mouth and open wounds. Frequent application ensures continuous protection. Insect repellent may also be applied to clothing.
- Wear long sleeves, long pants, hats and shoes rather than sandals.