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malaria Bwindi gorilla trek is one of Africa’s most extraordinary wildlife experiences, connecting travellers with mountain gorillas in their natural forest habitat. Malaria is present around Bwindi, so you need antimalarial tablets for a gorilla trek in Uganda, even though the risk is lower in the cool hills than in the lowlands. Altitude, on the other hand, is rarely a serious problem. Bwindi’s trekking areas lie between about 1,200 and 2,600 m, high enough to make you breathe harder on steep climbs but generally too low for altitude sickness. This guide explains the real malaria risk at each stage of a gorilla safari, how to avoid bites, and what the altitude means for your trek.
Mosquitoes, malaria, and altitude health on a Uganda gorilla trek
Malaria risk on a gorilla safari
Uganda has one of the highest malaria burdens in the world, almost all of it the dangerous Plasmodium falciparum type. Risk is highest in the warm lowlands: around Lake Victoria at Entebbe and Kampala, in Queen Elizabeth and Murchison Falls national parks, and along the main roads west. Most travellers spend time in these places at the start and end of a trip, so that is where most of their exposure happens.
The highlands around Bwindi are cooler, and mosquitoes breed and develop the parasite more slowly at altitude, so transmission is lower. It is not absent. Buhoma, in the north of Bwindi, sits at around 1,500 m, and malaria is one of the most common illnesses treated at the local hospital. Higher areas such as Ruhija, at about 2,300 m, have much lower risk, but the highland districts of Kabale and Kisoro have had malaria epidemics in the past. Travel health services advise antimalarials for the whole of Uganda.
Antimalarial tablets
The usual options are atovaquone-proguanil (Malarone or generics), doxycycline and mefloquine. Atovaquone-proguanil is taken daily, starting a day or two before arrival and for seven days after leaving, and suits short trips. Doxycycline is cheap but must be taken for four weeks after the trip and can make skin more sensitive to sun. Mefloquine is weekly but not suitable for everyone. A travel clinic will recommend the right one for your health and itinerary. Our guide to malaria prevention in Uganda compares them in detail.
Avoiding mosquito bites
Tablets are not 100% effective, so avoiding bites matters just as much. The malaria mosquito bites mainly from dusk to dawn. Use a repellent containing DEET (20–50%) or picaridin on exposed skin in the evening, wear long sleeves and trousers after sunset, and sleep under a net if your room is not screened. Most lodges provide nets. Clothing treated with permethrin adds protection. On the trek itself, during the day, mosquitoes are less of a concern than biting insects such as safari ants, which is another reason for long trousers tucked into socks.
If you get a fever
Any fever during the trip, or in the months after you return home, should be tested for malaria the same day, even if you took your tablets. Early symptoms such as fever, chills, headache and aches can feel like flu. Clinics in towns near Bwindi and Bwindi Community Hospital in Buhoma can do a rapid test within minutes, and treatment is effective if started early. At home, tell your doctor you have been in Uganda. See our guide to getting sick on a gorilla trekking trip.
What the altitude means
Bwindi spans roughly 1,160 to 2,600 m above sea level. Buhoma lies at the lower end, while Rushaga, Nkuringo and Ruhija trailheads are higher, around 2,000–2,300 m, and treks can climb further. Mgahinga is higher still, and the volcano climbs there reach well above 3,000 m. At Bwindi’s heights the air holds noticeably less oxygen than at sea level, so you will breathe harder on steep climbs, and some people feel a mild headache or tiredness on the first day.
Acute mountain sickness is uncommon below about 2,500 m and rare on a gorilla trek, but the climbs are steep. Arriving the day before your trek, drinking plenty of water and walking at a steady pace makes a real difference. Our guide to altitude and gorilla trekking covers this in more depth. For the Virunga volcano climbs, follow normal altitude advice and turn back if symptoms get worse.
Cold, sun and rain
Altitude also brings cool mornings, often 10–15°C in the higher sectors, and cold nights, so bring a warm layer even though Uganda is on the equator. The sun is strong when it breaks through, so use sunscreen and a hat on open stretches. Rain can fall at any time of year, and a light waterproof jacket is essential. Wet, muddy slopes cause far more injuries on gorilla treks than altitude does, so good boots and a walking stick matter.
Other health preparation
A yellow fever vaccination certificate is required to enter Uganda. Travel clinics usually also recommend vaccines such as hepatitis A, typhoid and tetanus, and sometimes rabies or hepatitis B. Visit a clinic six to eight weeks before you travel. Remember that rangers can turn away trekkers with a cold, cough or other infection, because gorillas catch human illnesses easily. A permit costs US$800 (US$600 in April, May and November) and is not refunded if you are too ill to trek, which makes travel insurance essential. See our guide to vaccinations for Uganda.
Frequently asked questions
Yes, though the risk is lower than in Uganda’s lowlands because of the altitude. Antimalarial tablets are recommended for the whole trip.
It is rare. Bwindi is mostly between about 1,200 and 2,600 m, high enough to make you breathe harder but usually too low for altitude sickness.
Atovaquone-proguanil, doxycycline and mefloquine are all used. A travel clinic will recommend the right one for you.
Mainly from dusk to dawn, so use repellent and cover up in the evening and sleep under a net.
