Importation of malaria into the USSR from Afghanistan, 1981-89

Between 1981 and 1989, a total of 7683 cases of Plasmodium vivax [corrected] malaria were imported into the USSR from Afghanistan, mainly by demobilized military personnel. For 23.8% of these cases the clinical manifestations appeared within a month of returning to the USSR, for 22.5% after 1-3 months, for 20% after 4-6 months, for 2% after > 1 year, and for 0.6% after > 2 years. For 13 patients the clinical manifestations of malaria appeared 3 years after returning from Afghanistan (up to 38 months). Nearly 69% of the patients did not take malaria prophylaxis at all while they were in Afghanistan, and 19% took chloroquine irregularly. Only 12.5% of the patients received a full course of prophylactic treatment with primaquine before leaving Afghanistan. A total of 56% of the cases were detected during the period most favourable for malaria transmission in the USSR (May-September) and of these, half were imported into formerly malarious areas of the country. Activation of a surveillance system greatly reduced the consequences of the massive importation of malaria, to which the local vectors were susceptible.