Schwartz E, Paul F, Pener H, Almog S, Rotenberg M, Golenser J
The Center for Geographical Medicine, Sheba Medical Center, Tel-Hashomer, Israel.
J Travel Med. 2001 May-Jun;8(3):113-6. doi: 10.2310/7060.2001.24436.
The United Nations deployed about 8,000 soldiers in a peacekeeping mission in Angola. Malaria is the most common disease there and consequently it was the major risk to the UN troops. Most of them are from malaria free areas. As a result of improper prophylactic measures there were many cases of malaria, including some deaths in 1995. In February-March 1996, an Israeli team was sent to Angola to evaluate the malaria situation among UN soldiers. This paper deals specifically with some aspects of chemoprophylaxis and diagnosis. The efforts were concentrated in one particular area where malaria incidence had been reported as the highest.
Blood samples were collected from nonimmune soldiers who were using mefloquine as a prophylactic drug and were exposed to malaria. The mefloquine and the antimalarial antibody plasma levels were monitored.
While the local laboratory indicated that about 80% had a malaria episode, the serological results revealed that only 5 soldiers of the 56 (9%) examined had antimalarial antibodies, of which 3 were Angolans. Despite a controlled prophylactic regimen there was considerable variability in mefloquine plasma levels: 46% of the samples were below the required prophylactic level and 26% above it. All patients who were proven positive with malaria by both microscopic and serologic observation had a low level of mefloquine.
In field conditions, a kit which identifies plasmodial antigens, is preferable, to a microscopic diagnostic method. Controlled mefloquine prophylaxis may not prevent malaria, especially when blood levels are low. The reason for the low mefloquine blood levels is not clear and needs further evaluation.
联合国在安哥拉的维和行动中部署了约8000名士兵。疟疾是当地最常见的疾病，因此也是对联合国部队的主要威胁。他们中的大多数来自无疟疾地区。由于预防措施不当，出现了许多疟疾病例，包括1995年的一些死亡病例。1996年2月至3月，一支以色列团队被派往安哥拉评估联合国士兵中的疟疾情况。本文专门探讨化学预防和诊断的一些方面。工作集中在一个据报道疟疾发病率最高的特定地区。
从使用甲氟喹作为预防药物且接触过疟疾的非免疫士兵中采集血样。监测甲氟喹和抗疟疾抗体的血浆水平。
当地实验室表明约80%的人有疟疾发作，但血清学结果显示，在接受检查的56名士兵中只有5人（9%）有抗疟疾抗体，其中3人是安哥拉人。尽管有可控的预防方案，但甲氟喹血浆水平仍有很大差异：46%的样本低于所需的预防水平，26%高于该水平。所有经显微镜和血清学观察证实为疟疾阳性的患者甲氟喹水平都很低。
在野外条件下，一种能识别疟原虫抗原的试剂盒比显微镜诊断方法更可取。可控的甲氟喹预防可能无法预防疟疾，尤其是当血液水平较低时。甲氟喹血液水平低的原因尚不清楚，需要进一步评估。
