Study Tracks U.S. Military Members' Malaria Rates

Malaria rates among members of the U.S. military who were born in western Africa were 44 times higher during 2002-2010 than rates for members who were born in the United States, authors of a paper being published in the September issue of CDC's Emerging Infectious Diseases journal report.

A study being published in the September issue of CDC's Emerging Infectious Diseases journal found that malaria rates among members of the U.S. military who were born in western Africa were 44 times higher during 2002-2010 than rates for members who were born in the United States. The authors -- Ellen R. Wertheimer, John F. Brundage, and Mark M. Fukuda from the Armed Forces Health Surveillance Center in Silver Spring, Md. -- report that military members account for 5 to 10 percent of all malaria cases reported in the United States.

Still, their analysis of the U.S. armed forces' routine health surveillance data for this period found only 835 total cases of malaria, with the United States, Nigeria, and Ghana being the most frequent known birth countries among those patients. The highest rates were for military members who had been born in Cote d'Ivoire, Togo, Cameroon, and Ghana. The 30.5 per 100,000 person-years rate for those born in seven western African countries was 44 times higher than the 0.70 rate for U.S.-born members.

Their explanation for the higher rate for this population group is simple: Most of the malaria infections acquired by those who were born in western Africa "were probably acquired during visits to their birth countries," the authors concluded. U.S. military members are informed of malaria risks and countermeasures before deploying to malaria-endemic areas, but before personal travel, counseling about malaria prevention may not be readily available and use of countermeasures isn't enforced, they wrote.

People who live in malaria-endemic countries develop partial immunity from repeated exposure to malaria parasites, but this immunity wanes when they leave their country of origin; the military members may not realize this. They recommend pretravel counseling and encouraging compliance with chemoprophylactic regimens before, during, and after visits to birth countries.

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