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Malaria in the Republic of Djibouti, 1998–2009
Lénaïck Ollivier
Lénaïck Ollivier
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Remington L. Nevin
Remington L. Nevin
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Houssein Y. Darar
Houssein Y. Darar
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Jacques Bougère
Jacques Bougère
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Moustapha Saleh
Moustapha Saleh
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Stéphane Gidenne
Stéphane Gidenne
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Jérôme Maslin
Jérôme Maslin
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Dietmar Anders
Dietmar Anders
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Christophe Decam
Christophe Decam
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Alain Todesco
Alain Todesco
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Bouh A. Khaireh
Bouh A. Khaireh
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Ammar A. Ahmed
Ammar A. Ahmed
Direction Centrale du Service de Santé des Armées, Paris, France; Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana; Hôpital Général Peltier, Djibouti, Republic of Djibouti; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti; Laboratoire Ketterthill, Esch sur Alzette, Luxembourg; Hôpital d'Instruction Sainte Anne, Toulon, France; Marinefliegergeschwader 3 Bundeswehr, Nordholz, Germany; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Marseille, France; Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti; Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti
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Historically, native populations in the Republic of Djibouti have experienced only low and unstable malaria transmission and intermittent epidemics. In recent years, efforts at malaria control have been aggressively pursued. This study was performed to inform revised malaria prevention recommendations for military service members and international travelers to the country. Laboratory-confirmed cases of malaria documented at large medical facilities and within military and civilian health care systems in the Republic of Djibouti from 1998 to 2009 were reviewed. In recent years, fewer than 5% of febrile cases among the three largest passive surveillance systems were laboratory-confirmed as malaria, and incidence of confirmed malaria was well below 1/1,000 persons/year. As efforts in the Republic of Djibouti progress toward elimination, and in conjunction with continued efforts at surveillance, emphasizing mosquito-avoidance measures and standby emergency treatment will become reasonable recommendations for malaria prevention.
Author Notes
Financial support: This study was principally supported through funds from the French forces Fight against Malaria Master Plan. The French forces reviewed this manuscript before publication and have no objection to its publication.
Authors' addresses: Lénaïck Ollivier, Direction Centrale du Service de Santé des Armées, Fort Neuf de Vincennes, Cours des Maréchaux, Paris Cedex 12, France, E-mail: lenaickollivier@hotmail.com. Remington L. Nevin, Department of Preventive Medicine, Bayne-Jones Army Community Hospital, Fort Polk, LA, E-mail: remington.nevin@us.army.mil. Houssein Y. Darar, Hôpital Général Peltier, Djibouti, Republic of Djibouti, E-mail: yhoussein@yahoo.fr. Jacques Bougère, Christophe Decam, and Alain Todesco, Institut de Recherche Biomédicale des Armées – Antenne de Marseille, Allée du Médecin Colonel Jamot, Parc du Pharo, Marseille cedex 07, France, E-mails: jacquesbougere@yahoo.fr, christophe2km@netcourrier.com, and ens@imtssa.fr. Moustapha Saleh, Caisse National de Sécurité Sociale, Djibouti, Republic of Djibouti, E-mail: djibpharma@intnet.dj. Stéphane Gidenne, Laboratoire Ketterthill, Luxembourg, E-mail: stephane.gidenne@ketterthill.lu. Jérôme Maslin, Hôpital d'Instruction Sainte Anne, Toulon, France, E-mail: maslin_j@yahoo.com. Dietmar Anders, Marinefliegergscwader 3 Bundeswehr, Nordholz, Germany, E-mail: dietmaranders@bundeswehr.org. Bouh A. Khaireh, Service de Santé des Forces Armées Djiboutiennes, Djibouti, Republic of Djibouti, E-mail: bouh.abdi@yahoo.fr. Ammar A. Ahmed, Direction de l'Epidémiologie et de l'Information Sanitaire, Djibouti, Republic of Djibouti, E-mail: ammarmed@yahoo.com.
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-
1.
Rodhain F, 1976. Preliminary results of an entomological survey of the potential arbovirus vectors in the French Territory of Afars and Issas. Bull Soc Pathol Exot Filiales 69: 169–174.
-
2.
Ollivier L, Decam C, Pommier de Santi V, Darar HY, Dia A, Nevin RL, Romand O, Bougère J, Deparis X, Boutin JP, 2010. Gastrointestinal illnesses among French forces deployed to Djibouti: French military health surveillance, 2005–2009. Am J Trop Med Hyg 83: 944–950.
-
3.
Rodier GR, Parra JP, Kamil M, Chakib SO, Cope SE, 1995. Recurrence and emergence of infectious diseases in Djibouti city. Bull World Health Organ 73: 755–759.
-
4.
Carteron B, Morvan D, Rodhain F, 1978. The question of endemic malaria in the Republic of Djibouti. Med Trop (Mars) 38: 299–304.
-
5.
Rodhain F, 1977. Mosquitoes of the French Territory of the Afars and Issas. I. The genus Anopheles. Bull Soc Path Exot Filiales 70: 302–330.
-
6.
Metselaar D, van Thiel PH, 1959. Classification of malaria. Trop Geogr Med 11: 157–161.
-
7.
Carteron B, Morvan D, Rodhain F, 1979. The control of culicidae in Djibouti town. An experience of 7 years. Med Trop (Mars) 39: 555–558.
-
8.
Louis JP, Albert JP, 1988. Malaria in the Republic of Djibouti. Strategy for control using a biological antilarval campaign: indigenous larvivorous fishes (Aphanius dispar) and bacterial toxins. Med Trop (Mars) 48: 127–131.
-
9.
Fox E, Abbate EA, Leef M, Mikhail E, Said-Salah Y, Hassan A, 1989. Malaria in the Djibouti Republic. Results of a serologic survey in Ambouli. Med Trop (Mars) 49: 159–160.
-
10.
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