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Falciparum malaria: an outbreak in a military population on an operational deployment
Jeremy Tuck1, Andrew Green, Kenneth Roberts
15 General Support Medical Regiment, Fulwood Barracks, Preston, Lancashire, UK, PR2 8AA.
Background:
In May 2000, the United Kingdom deployed a joint force to Sierra Leone on an operation covering four phases. Each phase was characterized by high exposure risk of falciparum malaria but with varying risks due to the combat environment that affected implementation of malarial protection policy.
Aim:
This study will describe the risks managed concerning malarial protection for the force and match these to the attack rates (AR) suffered by the force.
Methods:
The evidence concerning current malarial protection will be revisited. The risks attributable to disease and combat environment will be described and AR calculated using disease notifications as the numerator and operational personnel returns as the denominator.
Results:
ARs appeared to be higher where the risk of hostile activity was higher. The evidence base concerning the use of malarial protection measures remains valid. The AR associated with deployment of a force to a high malaria risk area with a high associated risk of hostile action appears to be 0.78 cases per person-years exposure. The AR for personnel deployed to a high malaria risk area with a low risk of hostile action appears to be 0.078 cases per person-years exposure.
Insights
Military malaria attack rates (AR) were higher in high-risk combat zones. Effective malaria protection policies remain crucial for deployed forces, even in challenging environments.
Area of Science:
- Military medicine
- Tropical disease epidemiology
Background:
- United Kingdom joint force deployed to Sierra Leone in May 2000.
- Operation involved four phases with high falciparum malaria exposure risk.
- Combat environment influenced malaria protection policy implementation.
Purpose of the Study:
- Describe malaria protection risks managed for the deployed force.
- Correlate managed risks with malaria attack rates (AR).
Main Methods:
- Review existing malaria protection evidence.
- Describe disease and combat environment risks.
- Calculate AR using disease notifications and personnel returns.
Main Results:
- Higher AR observed in areas with greater hostile activity risk.
- Malaria protection measures evidence base remains valid.
- AR was 0.78 cases/person-years in high-risk/high-hostility areas.
- AR was 0.078 cases/person-years in high-risk/low-hostility areas.
Conclusions:
- Combat environment significantly impacts malaria attack rates.
- Consistent application of malaria protection is vital.
- Risk assessment and policy are critical for force health protection in endemic zones.