Confirmed malaria cases among active component U.S. Army personnel, January-September 2012

Of 26 cases of malaria reported among active component U.S. Army personnel during January through September 2012, 16 were laboratory-confirmed according to electronic medical records. Medical records and responses on postdeployment health assessment questionnaires were used to assess demographic and clinical characteristics, adherence to malaria prevention measures, and compliance with prescriptions for chemoprophylaxis. All but two cases were confirmed by peripheral blood smears. Twelve cases were caused by Plasmodium vivax, one by P. falciparum, and three unspecified diagnoses were deemed likely to be due to P. vivax. Fourteen cases were associated with deployment to Afghanistan. Adherence to Army malaria prevention measures during deployment and compliance with post-deployment primaquine chemprophylaxis were poor. Prescribed doses of primaquine often varied from current clinical or Department of Defense policy guidelines. Continued education, training and reinforcement of malaria prevention by medical and preventive medicine personnel are indicated, as is blood smear confirmation of suspected malaria cases. Unit commanders and supervisors play a crucial role in ensuring soldiers' adherence to malaria prevention measures.