EPIDEMIOLOGY OF MALARIA AMONG UNITED STATES GOVERNMENT PERSONNEL ASSIGNED TO DIPLOMATIC POSTS

• Published in: The American journal of tropical medicine and hygiene Vol. 76; no. 2; pp. 260 - 266
• Main Authors: RATHNAM, PRIYA JOY, BRYAN, JOE P, WOLFE, MARTIN
• Format: Journal Article
• Language: English
• Published: Lawrence, KS ASTMH 01.02.2007; Allen Press
• Subjects: Adult; Africa South of the Sahara - epidemiology; Aged; Animals; Asia, Southeastern - epidemiology; Biological and medical sciences; Female; Human protozoal diseases; Humans; Incidence; Infectious diseases; Malaria; Malaria, Falciparum - epidemiology; Malaria, Falciparum - parasitology; Male; Medical sciences; Middle Aged; Parasitic diseases; Plasmodium falciparum; Plasmodium falciparum - growth & development; Protozoal diseases; Seasons; United States - ethnology; United States; North America; America; Asia, Southeastern; Africa South of the Sahara; Asia; USA; Africa; Infection; Human; Protozoal disease; Malaria; Government; Tropical medicine; Parasitosis; Personnel; Epidemiology; Public health
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.2007.76.260

The epidemiology of malaria among U.S. government personnel attached to diplomatic posts has not been reported. We reviewed malaria surveillance reports on persons with onset of symptoms between January 1988 and December 2004. Among 684 slide-proven cases, the median age was 36 years. There were 565 (82.6%) cases of Plasmodium falciparum malaria and 56 (8.2%) of P. vivax malaria. A total of 89.9% were infected in Africa and 5.8% were infected in Asia; 95% of the P. falciparum cases originated in sub-Saharan Africa. One-fourth of all cases were reported in 1990-1991. The average annual incidence (per 1,000 personnel) of Plasmodium between 1995 and 1999 was highest in west Africa (8.96), followed by central Africa (8.08), and east Africa (4.27). No or irregular chemoprophylaxis was reported by 58.5%. Among those who indicated regular prophylaxis, 78% took regimens no longer considered adequate. In sub-Saharan Africa, cases were reported in every month. There were three deaths. Prevention of malaria among U.S. Government employees attached to diplomatic posts should particularly focus on those serving in sub-Saharan Africa and malarious areas of Asia.