Malaria on a Military Peacekeeping Operation: A Case Study with No Cases

Houston, David J.; Tuck, Jeremy

doi:10.7205/milmed.170.3.193

Cited by 9 publications

(11 citation statements)

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“…In such conditions, the soldiers were probably more closely supervised by the command, so they were submitted to a higher pressure to comply with the chemoprophylaxis. Indeed, the good health of the soldiers, including the prevention of malaria, was an important concern of the command because of the operational nature of the mission: the global health of the group had to be preserved for a military purpose [46]. Compliance with malaria chemoprophylaxis was also better among civilian travellers who were taking part in an organized trip compared to those traveling independently [35].…”

Section: Discussionmentioning

confidence: 99%

Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

Resseguier

Machault

Ollivier

et al. 2010

Malar J

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BackgroundThe effectiveness of malaria chemoprophylaxis is limited by the lack of compliance whose determinants are not well known.MethodsThe compliance with malaria chemoprophylaxis has been estimated and analysed by validated questionnaires administered before and after the short-term missions (about four months) in five tropical African countries of 2,093 French soldiers from 19 military companies involved in a prospective cohort study. "Correct compliance" was defined as "no missed doses" of daily drug intake during the entire mission and was analysed using multiple mixed-effect logistic regression model.ResultsThe averaged prevalence rate of correct compliance was 46.2%, ranging from 9.6%to 76.6% according to the companies. Incorrect compliance was significantly associated with eveningness (p = 0.028), a medical history of clinical malaria (p < 0.001) and a perceived mosquito attractiveness inferior or superior to the others (p < 0.007). Correct compliance was significantly associated with the systematic use of protective measures against mosquito bites (p < 0.001), the type of military operations (combat vs. training activities, p < 0.001) and other individual factors (p < 0.05).ConclusionsThe identification of circumstances and profiles of persons at higher risk of lack of compliance would pave the way to specifically targeted strategies aimed to improve compliance with malaria chemoprophylaxis and, therefore, its effectiveness.

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Section: Discussionmentioning

confidence: 99%

Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

Resseguier

Machault

Ollivier

et al. 2010

Malar J

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“…Moreover, a preventive approach is curtailing the introduction of resistant malaria to drug sensitive regions 23 . A British study done in 2015 on 512 soldiers stationed at a high risk area, reported that no cases develop if the chain of command is proactive about the implementation of malaria prevention policies 24 .…”

Section: Discussionmentioning

confidence: 99%

Malarial Parasite Screening of Troops Returning From Un Mission to Pakistan

Khan

Shaheen

Khan

2021

PAFMJ

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Objective: To establish efficacy of malaria prevention programs by screening troops returning from UN peacekeeping services in high risk areas in Africa for malarial parasites. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital, Kharian, from Jan 2017 to Jan 2019. Methodology: In this cross sectional study, individuals of regiments returning to Pakistan from high risk areasin Africa were screened for malarial parasites. A total of 1632 samples were analyzed during this time frame.Informed consent was taken at the individual and institutional level. Blood samples obtained from each participant were tested by both immuno-chromatographic techniques and peripheral blood films. Results: Total 1632 individuals were screened for malarial parasites. Peripheral blood slides were negative in allindividuals except one. Immuno-chromatographic techniques for detection of malarial parasites were positive in 17 individuals for Plasmodium falciparum antigen. Only one individual had both Plasmodium vivax and Plasmodium falciparum positivity via both methods. All of them were asymptomatic at the time of screening, had a past history of high grade fever treated with anti-malarial drugs and were admitted for observation and follow up. Conclusion: Despite the high prevalence of malaria in Africa, the current prevention protocols prove to be highly efficacious in protecting UN peace-keeping forces from infection and lowering mortality rates.

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“…They have also trialled text messaging to successfully confirm the daily ingestion of malaria chemoprophylaxis in a deployed setting 14. Many of these measures have been effectively implemented by the UK Armed Forces in the past15 and when these standards have slipped malarial outbreaks have occurred 16 17. In the case of this patient, as a civilian healthcare worker for an NGO, none of these measures were used, aside from the use of mosquito nets.…”

Section: Discussionmentioning

confidence: 99%

A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness: Table 1

et al. 2015

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We present a 27-year old British nurse admitted to the Kerry Town Ebola Treatment Unit, Sierra Leone, with symptoms fitting suspect-Ebola virus disease (EVD) case criteria. A diagnosis of Plasmodium falciparum malaria and heat illness was ultimately made, both of which could have been prevented through employing simple measures not utilised in this case. The dual pathology of her presentation was atypical for either disease meaning EVD could not be immediately excluded. She remained isolated in the red zone until 72 h from symptom onset. This case highlights why force protection measures are important to reduce the incidence of both malaria and heat illness in deployed military and civilian populations. These prevention measures are particularly pertinent during the current EVD epidemic where presenting with these pathologies requires clinical assessment in the 'red zone' of an Ebola treatment unit.

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Malaria on a Military Peacekeeping Operation: A Case Study with No Cases

Abstract: The chain of command can have a significant impact on compliance with malaria protection measures, which might reduce incidence of the disease in the deployed population.

Cited by 9 publications

References 0 publications

Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

Malarial Parasite Screening of Troops Returning From Un Mission to Pakistan

A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness: Table 1

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