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Malaria
Overview of malaria in Africa and preventive measures.

In late 2009, malaria claimed the life of a US Navy member who had been deployed to Africa. Malaria has been labeled the signature disease of concern by the US Africa Command Surgeon, precisely because it is deadly in travelers and deployers but can be prevented with the assiduous use of many low-tech personal protective measures.


The Malaria Parasite

 

infection cycle of the Plasmodium falciparum/falciparum malaria parasite

 

Malaria is a disease caused by a parasite (called Plasmodium) that infects red blood cells. The parasite is transmitted from person to person through the bite of mosquitoes. Malarious mosquitoes typically bite from dusk to dawn, particularly inside structures when and where people sleep.

Avoiding mosquito bites is the only sure way to prevent malaria infection, and there are medicines that travelers can take to minimize their chances of contracting the illness in case a mosquito bite inadvertently occurs.

There is no vaccine available for the prevention of malaria in travelers. The Centers for Disease Control and Prevention has made available extensive information about the prevention of malaria in travelers. US Army Public Health Command is another source for concise malaria information [PDF icon]

Although several species of malaria exist, the most deadly species is also the most commonly encountered in sub-Saharan Africa (Plasmodium falciparum, or falciparum malaria).

Estimates vary, but falciparum malaria is responsible for approximately a million deaths each year, ninety percent of which occur in children under five years. The World Health Organization compiles information about the impact of malaria on Africa.

World Health Org map of global malaria
Map courtesy World Health Organization (2010 data)


 

Avoiding Bites = Avoiding Malaria

 

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Personal Protective Measures

Personal protective measures to avoid mosquito bites include

  • Pre-treating clothing/uniforms with permethrin (per-METH-rin) insecticide/repellent
  • Covering most of your body with permethrin-treated clothing
  • Applying DEET-containing insect repellent to exposed skin
  • Sleeping under an insecticide-treated bed net where air conditioning is not available
  • Avoiding dusk-to-dawn outdoor activities

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Bed Nets

Pre-treated, pop-up bed nets weighing only two pounds are issued to HQ USAFRICOM personnel.

 

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Preventative Medications

Medications to prevent malaria are not 100% effective and have side effects that may limit their use; therefore, a malaria medication is only the last line of defense to prevent infection. In a deployed setting or enduring site, mosquito control programs add another layer of protection from malaria infection.

 

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Official Travel/Deployment Orders Requirements

Military members, civilians and contractors on official travel or deployment orders from HQ US Africa Command must attend a Travel Soldier Readiness Process (Travel-SRP, also known as the "Travel Clinic") at the Kelley Annex Clinic (Kelley Barracks), present to Medical Readiness at the Stuttgart Army Health Clinic (Patch Barracks), or seek an appointment with their medical provider prior to travel to Africa.

At the Travel-SRP, individuals receive education and counseling about typical and itinerary-specific health risks (and their mitigation), travel-appropriate immunizations, travel medications, repellents (DEET and permethrin), and instructions regarding the safe use of the above. For appointments with the Travel SRP, contact Central Appointments at DSN 371-2622. For any additional questions please call the Kelley Annex at DSN 421-5605.

The Travel SRP's General Counseling for the Traveler to Africa [PDF icon] document is available in PDF format for review.

 

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Information for Health Care Providers

Military health care providers may find the Malaria Field Guide (Technical Guide 336) [PDF icon] useful when counseling or taking care of individuals traveling to, or returning from, a malarious area.

 

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Lessons Learned

As documented by the US Army Medical Department, military experience with malaria is long and storied. Many frustrating lessons have been learned and re-learned over time, and military researchers have made important scientific contributions in malaria research and drug development. Every January, the Armed Forces Health Surveillance Center publishes malaria statistics in the Medical Surveillance Monthly Report [PDF icon].  Search for "malaria surveillance" for latest report.

 


 

 

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