Importation of chloroquine-resistant Plasmodium falciparum by Guatemalan peacekeepers returning from the Democratic Republic of the Congo

Details

• Alternative Title:
  Malar J
• Personal Author:
  Juliao, Patricia C ; Sosa, Silvia ; Gonzalez, Luis D ; Padilla, Norma ; Ortiz, Lucia ; Goldman, Ira ; Udhayakumar, Venkatachalam ; Lindblade, Kim A
• Description:
  Background
  
  Malaria elimination is being pursued in five of seven Central American countries. Military personnel returning from peacekeeping missions in sub-Saharan Africa could import chloroquine-resistant Plasmodium falciparum, posing a threat to elimination and to the continued efficacy of first-line chloroquine (CQ) treatment in these countries. This report describes the importation of P. falciparum from among 150 Guatemalan army special forces and support staff who spent ten months on a United Nations’ peacekeeping mission in the Democratic Republic of the Congo (DRC) in 2010.
  
  Methods
  
  Investigators reviewed patients’ medical charts and interviewed members of the contingent to identify malaria cases and risk factors for malaria acquisition. Clinical specimens were tested for malaria; isolated parasites were characterized molecularly for CQ resistance.
  
  Results
  
  Investigators identified 12 cases (8%) of laboratory-confirmed P. falciparum infection within the contingent; one case was from a soldier infected with a CQ-resistant pfcrt genotype resulting in his death. None of the contingent used an insecticide-treated bed net (ITN) or completely adhered to malaria chemoprophylaxis while in the DRC.
  
  Conclusion
  
  This report highlights the need to promote use of malaria prevention measures, in particular ITNs and chemoprophylaxis, among peacekeepers stationed in malaria-endemic areas. Countries attempting to eliminate malaria should consider appropriate methods to screen peacekeepers returning from endemic areas for malaria infections. Cases of malaria in travellers, immigrants and soldiers returning to Central America from countries with CQ-resistant malaria should be assumed to be carry resistant parasites and receive appropriate anti-malarial therapy to prevent severe disease and death.
  
  
• Subjects:
  Adult Antimalarials Chloroquine Drug Resistance Humans Malaria, Falciparum Male Middle Aged Military Personnel Plasmodium Falciparum Research Travel Young Adult

  More +
• Source:
  Malar J. 2013; 12:344.
• Pubmed ID:
  24060234
• Pubmed Central ID:
  PMC3849196
• Document Type:
  Journal Article
• Funding:
  UO1 GH000028-02/GH/CGH CDC HHS/United States
• Place as Subject:
  Democratic Republic of the Congo ; Guatemala
• Volume:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f2255fe1d9f24ef2fb4356701d855da027a90d62070be9f6da5bc005e00086f8
• Download URL:
  https://stacks.cdc.gov/view/cdc/21369/cdc_21369_DS1.pdf
• File Type:
  [PDF - 202.83 KB ]