Only Australia, Estonia, Finland, Grenada, Iceland and New Zealand, met the World Health Organization's air quality guidelines, according to IQAir, a company that tracks air quality.
Seven territories in the Pacific and Caribbean also met the threshold, which calls for an average air pollution level of 5 micrograms per cubic meter or less.
The study looked at fine particulate matter, or PM2.5, which comes from fossil fuels, dust storms and wildfires. It has been linked to a number of respiratory illnesses.
Chad topped the list of countries with the worst air pollution, registering a level of 89.7 micrograms per cubic meter.
"If you look at what's called satellite or modeled data, Africa is supposed to be probably the most polluted continent on the planet, but we don't have enough data," Glory Dolphin Hammes, CEO of IQAir North American, told CNN. "What that means is there's a whole lot more data that's needed in order for us to truly determine what are the most polluted countries and cities in the world."
Thirty-nine of the 50 cities with the worst air pollution were in India, which also ranked as one of the worst countries in overall pollution.
Air pollution improved in the United States last year due to a mild wildfire season.
Columbus, Ohio; Atlanta and Chicago topped the list of major US cities with the worst air quality.
Hammes attributed the global rise in air pollution to the continued burning of fossil fuels.
"This is literally about how we as a planet are continuing this unhealthy relationship with fossil fuels," said Hammes. "We are still dependent on fossil fuels and fossil fuels are responsible for the majority of air pollution that we encounter on this planet."
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