Newton J A, Schnepf G A, Wallace M R, Lobel H O, Kennedy C A, Oldfield E C
Department of Internal Medicine, Naval Medical Center, San Diego, Calif. 92134-5000.
JAMA. 1994 Aug 3;272(5):397-9.
To identify malaria in US Marines returning from Somalia and to determine their compliance with chemoprophylaxis.
Case series.
The US Navy health care system.
Consecutive sample of 106 US Marines diagnosed with malaria after returning from Somalia in 1993.
Identification of the incidence and clinical features of imported malaria. Determination of compliance with chemoprophylaxis in this cohort.
As of December 20, 1993, there were 112 cases of imported malaria in 106 US Marine Corps personnel returning from Somalia. Plasmodium vivax accounted for 97 (87%) of 112 malaria cases, and Plasmodium falciparum accounted for eight (7%) of 112 cases. Mixed infection with P vivax and P falciparum was noted in six (5%) of 112 cases, and a single case of Plasmodium malariae was identified. Patients with P falciparum malaria were diagnosed a mean of 20.9 days (range, 1 to 82 days) after returning to the United States compared with 91.8 days (range, 7 to 228 days) for P vivax infection (P < .0001). The self-reported chemoprophylaxis compliance rate was 56%; however, only 45 (50%) of 90 patients were given an optimal chemoprophylaxis regimen.
Noncompliance with personal protective measures and chemoprophylaxis contributed to the largest outbreak of imported malaria in US military personnel since the Vietnam conflict. Since military personnel frequently go on leave after deployment, health care providers throughout the United States must be aware of the presence of imported malaria from Somalia.
识别从索马里返回的美国海军陆战队队员中的疟疾感染情况，并确定他们对化学预防措施的依从性。
病例系列研究。
美国海军医疗系统。
1993年从索马里返回后被诊断为疟疾的106名美国海军陆战队队员的连续样本。
确定输入性疟疾的发病率和临床特征。确定该队列中化学预防措施的依从性。
截至1993年12月20日，106名从索马里返回的美国海军陆战队队员中有112例输入性疟疾。间日疟原虫占112例疟疾病例中的97例（87%），恶性疟原虫占112例中的8例（7%）。112例中有6例（5%）为间日疟原虫和恶性疟原虫混合感染，还确诊了1例三日疟原虫感染。恶性疟原虫感染患者回到美国后平均20.9天（范围1至82天）被诊断，而间日疟原虫感染患者为91.8天（范围7至228天）（P <.0001）。自我报告的化学预防措施依从率为56%；然而，90名患者中只有45名（50%）接受了最佳化学预防方案。
不遵守个人防护措施和化学预防措施导致了自越南冲突以来美国军事人员中最大规模的输入性疟疾暴发。由于军事人员在部署后经常休假，美国各地的医疗服务提供者必须意识到存在来自索马里的输入性疟疾。
