A retrospective study on imported malaria in Jordan. 1. Malaria among Jordanian UN peacekeeping forces

Malaria is considered as one of the most threatening diseases affecting peacekeeping forces serving in malaria endemic countries. The Jordanian Armed Forces participated in many of the United Nations peacekeeping missions in over 20 countries across the world. Thin and thick blood smears were collected from military personnel returning to Jordan, and relevant data including occupation, age, sex, residence address and the country they served in were recorded. Mefloquine 250 mg/week was prescribed for prophylaxis during the period of stay for three contingents of Jordanian military forces deployed to East Timor. Members of two contingents were given post exposure prophylactic treatment of Doxycycline 100 mg coupled with Primaquine 15 mg daily for 14 days soon after returning to Jordan. Blood smears were taken from all soldiers suspected to be affected by malaria, and were monitored over a period of 15 weeks. A total of 811 malaria cases were reported during 1992-2011 among Jordanian military personnel whom served in over 20 countries. Most cases were reported among troops returning from Eretria (54.74%), East Timor (18.86%), Ivory Coast (9.12%) and Sierra Leone (5.1%). Troops aged between 20-40 years constituted 96.3% of the total reported cases. The majority of infections were due to Plasmodium vivax (83.5%), followed by Plasmodium falciparum (13.6%). The attack rates (AR) of malaria/100 soldiers among the three contingents were 10.8% for Timor 1, with no post-exposure prophylaxis, and 2.8% for Timor 2 and 3 with post-exposure prophylaxis. There was an evident reduction of malaria attack rate and relapse rate between the two groups Timor 1 (without post-exposure prophylaxis) and Timor 2 and 3 (given post exposure prophylaxis).