Remote sensing and malaria risk for military personnel in Africa.
BACKGROUND
Nonimmune travelers in malaria-endemic areas are exposed to transmission and may experience clinical malaria attacks during or after their travel despite using antivectorial devices or chemoprophylaxis. Environment plays an essential role in the epidemiology of this disease. Remote-sensed environmental information had not yet been tested as an indicator of malaria risk among nonimmune travelers.


METHODS
A total of 1,189 personnel from 10 French military companies traveling for a short-duration mission (about 4 mo) in sub-Saharan Africa from February 2004 to February 2006 were enrolled in a prospective longitudinal cohort study. Incidence rate of clinical malaria attacks occurring during or after the mission was analyzed according to individual characteristics, compliance with antimalaria prophylactic measures, and environmental information obtained from earth observation satellites for all the locations visited during the missions.


RESULTS
Age, the lack of compliance with the chemoprophylaxis, and staying in areas with an average Normalized Difference Vegetation Index higher than 0.35 were risk factors for clinical malaria.


CONCLUSIONS
Remotely sensed environmental data can provide important planning information on the likely level of malaria risk among nonimmune travelers who could be briefly exposed to malaria transmission and could be used to standardize for the risk of malaria transmission when evaluating the efficacy of antimalaria prophylactic measures.
Machault
Vanessa
V
Parasite Biology and Epidemiology Research Department, Institute for Tropical Medicine, French Military Service, Marseille Armées, France.
Orlandi-Pradines
Eve
E
Michel
Rémy
R
Pagès
Frédéric
F
Texier
Gaëtan
G
Pradines
Bruno
B
Fusaï
Thierry
T
Boutin
Jean-Paul
JP
Rogier
Christophe
C
D000328:Adult; D017954:Africa South of the Sahara; D000962:Antimalarials / Q000627:therapeutic use*; D015331:Cohort Studies; D019353:Endemic Diseases / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008288:Malaria / Q000517:prevention & control / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014195:Travel / Q000706:statistics & numerical data*
D000962:Antimalarials