The risk of imported malaria in security forces personnel returning from overseas missions in the context of prevention of re-introduction of malaria to Sri Lanka.

Sumadhya Deepika Fernando,Niroshana Senanayake,Geetha Epasinghe,Priyani Dharmawardana,Chaturaka Rodrigo,Saveen Semege,Risintha Premaratne

doi:10.1186/s12936-016-1204-y

Sumadhya Deepika Fernando, Niroshana Senanayake + Show 5 more

Open Access

https://doi.org/10.1186/s12936-016-1204-y

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Abstract

BackgroundSri Lanka is a malaria-free country. However it remains surrounded by countries with endemic malaria transmission. Since the last indigenous case of malaria was reported in October 2012, only imported malaria cases have been diagnosed with 36 cases detected in 2015, which includes 17 cases each of Plasmodium vivax and Plasmodium falciparum and two cases of Plasmodium ovale.MethodsThis study investigated the knowledge and practices regarding malaria chemoprophylaxis among all the Sri Lankan security forces personnel returning from peacekeeping missions in malaria endemic countries over a 7 month period. Adherence to other malaria prevention measures, occurrence of adverse events and incident cases of malaria were also recorded maintaining the anonymity of the respondents. Potential associations for non-compliance were studied.ResultsInterviews were carried out with 559 security forces personnel returning home from foreign deployments in malaria-endemic regions (males: 550, 98.4 %). The majority (553, 98.9 %) was well aware of the need for chemoprophylaxis during the overseas stay and its regular use as prescribed. The overall adherence to chemoprophylaxis was good with 78.7 % (440/559) reporting regular, as prescribed, use. Having better educational qualifications, being female, being prescribed mefloquine, having fever during deployment and belonging to a security force other than the army were significantly associated with poor compliance (p < 0.05).ConclusionsThe study reveals that knowledge regarding malaria chemoprophylaxis among Sri Lankan security forces personnel serving abroad was good, a fact that may have contributed to absence/extremely low incidence of malaria during deployment.

Highlights

IntroductionMalaria has made a comeback in many of the areas from which it was previously eliminated during the Global Malaria Eradication Programme
The security forces personnel included in this paper were members of Sri Lankan Army, Air Force, Police and Special Task Force who were deployed in United Nations peacekeeping missions abroad
Self reported adherence to chemoprophylaxis, occurrence of adverse events (AEs), mosquito bite prevention methods utilized abroad and getting tested for malaria following return to Sri Lanka were evaluated using a questionnaire with multiple choices

Summary

Introduction

Malaria has made a comeback in many of the areas from which it was previously eliminated during the Global Malaria Eradication Programme. This serves as a reminder that vigilant systems need to be sustained for Fernando et al Malar J (2016) 15:144. 60 % (189, 283/336, 640) of malaria cases reported in Sri Lanka between the years 2000 and 2012 were from these areas. In the last 5 years prior to elimination of local transmission (2008–2012), 2059 indigenous malaria cases were reported in Sri Lanka and 1547 of these (75 %) were from the members of the security forces [7]. With that the last indigenous case of malaria in Sri Lanka was reported in October 2012

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