Malaria among United States troops in Somalia

Wallace, Mark R.; Sharp, Trueman W.; Smoak, Bonnie L.; Iriye, Craig; Rozmajzl, Patrick J.; Thornton, Scott A.; Batchelor, Roger A.; Magill, Alan J.; Lobel, Hans O.; Longer, Charles F.; Burans, James P.

doi:10.1016/s0002-9343(96)90011-x

Cited by 100 publications

(61 citation statements)

References 22 publications

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“…Multiple studies in the Horn of Africa region suggest cases of malaria among international military service members are predominantly associated with non-compliance with both mosquito-avoidance measures and chemoprophylaxis. [24][25][26][27] Well-designed population studies have also confirmed poor compliance to chemoprophylaxis during prolonged military operations in the region. 28 As Djibouti progresses toward malaria elimination, opportunities will emerge for military personnel and international travelers to the country to forgo year-round chemoprophylaxis.…”

Section: Discussionmentioning

confidence: 96%

Malaria in the Republic of Djibouti, 1998–2009

Ollivier¹,

Nevin²,

Darar³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Historically, native populations in the Republic of Djibouti have experienced only low and unstable malaria transmission and intermittent epidemics. In recent years, efforts at malaria control have been aggressively pursued. This study was performed to inform revised malaria prevention recommendations for military service members and international travelers to the country. Laboratory-confirmed cases of malaria documented at large medical facilities and within military and civilian health care systems in the Republic of Djibouti from 1998 to 2009 were reviewed. In recent years, fewer than 5% of febrile cases among the three largest passive surveillance systems were laboratory-confirmed as malaria, and incidence of confirmed malaria was well below 1/1,000 persons/year. As efforts in the Republic of Djibouti progress toward elimination, and in conjunction with continued efforts at surveillance, emphasizing mosquito-avoidance measures and standby emergency treatment will become reasonable recommendations for malaria prevention.

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Section: Discussionmentioning

confidence: 96%

Malaria in the Republic of Djibouti, 1998–2009

Ollivier¹,

Nevin²,

Darar³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…17,18 Wallace and others previously demonstrated that malaria occurred in those who were noncompliant with both chemoprophylaxis and PPMs, particularly failure to use bed nets and to keep sleeves rolled down. 19 The latter is now part of official uniform wear policy for the U.S. military, underscoring the overall importance of command discipline to vector-borne disease prevention. In addition, Army combat uniforms are now treated with permethrin prior to their issuing to soldiers.…”

Section: Discussionmentioning

confidence: 99%

Safety, Tolerability, and Compliance with Long-Term Antimalarial Chemoprophylaxis in American Soldiers in Afghanistan

Saunders¹,

Garges²,

Manning³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Long-term antimalarial chemoprophylaxis is currently used by deployed U.S. military personnel. Previous small, short-term efficacy studies have shown variable rates of side effects among patients taking various forms of chemoprophylaxis, though reliable safety and tolerability data on long-term use are limited. We conducted a survey of troops returning to Fort Drum, NY following a 12-month deployment to Operation Enduring Freedom, Afghanistan from 2006 to 2007. Of the 2,351 respondents, 95% reported taking at least one form of prophylaxis during their deployment, and 90% were deployed for > 10 months. Compliance with daily doxycycline was poor (60%) compared with 80% with weekly mefloquine (MQ). Adverse events (AEs) were reported by approximately 30% with both MQ and doxycycline, with 10% discontinuing doxycycline compared with 4% of MQ users. Only 6% and 31% of soldiers reported use of bed nets and skin repellents, respectively. Compliance with long-term malaria prophylaxis was poor, and there were substantial tolerability issues based on these anonymous survey results, though fewer with MQ than doxycycline. Given few long-term antimalarial chemoprophylaxis options, there is an unmet medical need for new antimalarials safe for long-term use.

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“…Mefloquine and doxycycline are effective drugs for prophylaxis in sub-Saharan Africa but doxycycline has a short halflife and its usefulness is limited because of the need for daily dosing 6 and its contraindication in pregnant women and young children. In addition to chemoprophylaxis, Peace Corps volunteers are encouraged to use protective measures to reduce contact with mosquitoes.…”

Section: Discussionmentioning

confidence: 99%

“…20 The other series is the only report that has used valid and reliable criteria to confirm the diagnosis of malaria, document breakthrough levels, and assess which patients had drug levels sufficient for prophylactic effectiveness. 6 This study, however, evaluated only a select group of persons considered true prophylaxis failures among U.S. military personnel in Somalia.…”

Section: Discussionmentioning

confidence: 99%