Imported Malaria among Moroccan Military Personnel who have stayed in the Democratic Republic of Congo and C？te d’Ivoire

Malaria is a febrile and haemolyzing erythrocytopathy caused by the presence, development and multiplication of the Plasmodium genus protozoa in red blood cells, transmitted to humans by the bite of the female anopheles mosquito. It is a threat to travelers in general and in particular to military personnel from non-endemic countries and traveling to tropical regions. We tried to analyze the epidemiological, diagnostic, therapeutic and preventive characteristics of imported malaria, through a series of 81 cases of Moroccan soldiers who stayed in the Democratic Republic of Congo (DRC) and Ivory Cost (IC). The mean age was 33, 3 years, all male. 26 cases stayed in the DRC and 55 in the IC. We recorded one case of malaria in 2011, twentyseven cases in 2012, twelve in 2013, eighteen in 2014, and twenty three cases in 2015. The average time between the return from the endemic area and the onset of symptoms was 175 days. Fever was present in all cases and neurological disorders in one case. Plasmodium ovale was found in 55.5% of cases (n=45) followed by P. falcipaum in 39.5% (n=32). P. malariae was found in 3.4% of cases (n=3). The association P. falcipaum + P. ovale was observed only once (n=1). The average parasite rate was 0.69%, and it ranged from 0.01 to 8%. We regretted a single case of death due to P. ovale infection. Patients who were in the DRC used mefloquine in chemoprophylaxis, and those in IC used doxycycline until 2013, and then they converted to mefloquine. The Increase in the number of malaria cases imported from IC since 2012 appears to be due to the change of the place of deployment of half the Moroccan battalion deployed in the country. However, the increase in the number of cases from the DRC remains unexplained. Climatic factors or operational constraints could be the cause of their larger exposure to Anopheles risk. Keywords: Army; Democratic Republic of Congo; Imported malaria; Ivory Cost; Morocco