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ADF Health April 2003 - Volume 4 Number 1

Malaria Update

Malaria in the ADF, July-December 2002

NOTIFICATIONS OF MALARIA to the Central Malaria Register (CMR) at the Australian Army Malaria Institute (AMI) appear to have stabilised, with 14 notifications during the July to December 2002 reporting period, similar to the 13 notifications in the first six months of the year. This compares to 245 notifications for the first six months and 144 for the last six months of the year 2000, coinciding with the ADF's initial presence in East Timor with INTERFET. Reasons for the reduction in malaria cases were discussed in the previous issue. 1

The breakdown by malaria species and probable country of origin is detailed in the Table, and shows that East Timor remains the greatest source of malaria for the ADF.

Four of the 10 Plasmodium vivax malaria cases acquired from East Timor presented in the area of operations and all infected personnel were using doxycycline for prophylaxis. As previously discussed, 1 vivax malaria is usually more likely to present on return to Australia (RTA), and it is unusual for vivax malaria to outnumber infections with P. falciparum in the area of operations. Whilst these vivax infections in the area of operations probably indicate a breakdown in compliance and/or a decrease in bioavailability of doxycycline, it is prudent to keep in mind the possibility that P. vivax is developing tolerance of doxycycline.

Lieutenant Commander Sonya Bennett
Officer in Charge, Clinical Studies and Surveillance, Army Malaria Institute

Resources

1. Malaria in the ADF, January-June 2002. ADF Health 2002; 3: 96.

Malaria reporting

All Health Service personnel are encouraged to notify the Central Malaria Register promptly when a malaria casualty is detected. Informal notifications preceding a PM40 can be made by telephone (07 3332 4836) or by email (sonya.bennett@defence.gov.au).