title: Malaria control strategies in French armed forces.
abstract: Each year, 40,000 French soldiers deploy or travel through malaria-endemic areas. Despite the effective control measures that were successively implemented, malaria remains a public health concern in French armed forces with several important outbreaks and one lethal case every two years. This article describes the malaria control strategy in French armed forces which is based on three combined strategies: i) Anopheles vector control to prevent infection with the implementation of personal protection against vectors (PPAV) adapted to the field living conditions of the troops. ii) Chemoprophylaxis (CP) to prevent the disease based on prescription of effective and well tolerated doxycycline. iii) Management of cases through early diagnosis and appropriate treatment to prevent death. In isolated conditions in endemic areas, rapid diagnosis tests (RDT) are used as first-line tests by military doctors. Treatment of uncomplicated Plasmodium falciparum (P. falciparum) malaria is based either on the piperaquine tetraphosphate-dihydroartemisinin association since 2013, or on the atovaquone-proguanil association. First-line treatment of severe P. falciparum malaria is based on IV artesunate. These measures are associated with constant education of the military, epidemiological surveillance of malaria cases and monitoring of parasite chemosensitivity.
authors: Ecole du Val de Grâce, Paris, France. Electronic address: rene.migliani@santarm.fr.
authors: R
authors: R
authors: Migliani
authors: Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France; Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France.
authors: B
authors: B
authors: Pradines
authors: Centre d'épidémiologie et de santé publique des armées, Marseille, France.
authors: R
authors: R
authors: Michel
authors: Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, Saint-Mandé, France.
authors: O
authors: O
authors: Aoun
authors: Centre d'épidémiologie et de santé publique des armées, Marseille, France.
authors: A
authors: A
authors: Dia
authors: Ecole du Val de Grâce, Paris, France; Centre d'épidémiologie et de santé publique des armées, Marseille, France.
authors: X
authors: X
authors: Deparis
authors: Ecole du Val de Grâce, Paris, France; Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, Saint-Mandé, France.
authors: C
authors: C
authors: Rapp
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D005602:France; D006801:Humans; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel; D062486:Public Health Surveillance
chemical_list: D000962:Antimalarials
keywords: Control strategy; French armed forces; Malaria