World War One &Malaria
At least 1.5 million solders were infected
With case fatality ranging from 0.24--5.0%
As more countries become engaged in the
War ,the problem grew in size ,
Leading to major epidemics in Mesopotamia
Italy Macedonia and Palestine. Trans--
Continental passages of parasite and human
reservoirs of infection created ideal
Circumstances for passive evolution.
Clinical treatment primarily dependent
On quinine although efficacy was poor as
relapsing P.vivax and recrudescent Plasmodium
falciparum infections were not distinguished
and managed appropriately .
An unexpected adversary in the first
World war was malaria .It attacked all
combatant armies ,with adverse consequences
for vast number of troops ,and devasted large
Civilian populations as a result of the environmental civil and demographic efforts
Of troop dispersions and activities .
The world war malaria describes this
Paradigm.
By 1914 parts of Europe had made considerable progress in malaria control,
Particularly in Italy and Greece which
was
a major achievement considering that around
1900 the anopheline mosquito cycle was only
Just becoming a accepted ,and the important
Vectors as the development cycle in the red
Cell, were only recently recognized .
Soldiers tended to burrow
Underground which is conducive to
Water --logging and favourable to mosquito
Breeding.
The lack of knowledge of the hepatic
Stage of development of the P.vivax malaria
which was described in1948, compounded
the situation and was instrumental in
recurrently ineffective treatment being
Prescribed ,and evacuations of vast number
Sick troops from combat zones.
Malaria epidemics during the first
World war:Occurred in the regions
of Macedonia ,Palestine ,and Egypt
and western Europe , Italy and elsewhere.
An increased in vectorial capacity
due to high production of Anopheline
Mosquitoes was probably critical.
This could have resulted from more
Breading places (or deterioration of larval
Control ),prolong mosquito survival or
Increased man--vector contact .
In desert fringe regions rain fall and malaria
transmission are often connected.
The movement of infected persons,
as troops migrated from India and Sub --
Saharan , combined with the immigration
Of non immune European soldiers further
Created ideal conditions for the explosive
Epidemics which occurred .
Malaria control approaches ;
The greatest experience of preventive
measures was derived from activities
in Macedonia ,and these were applicable
To all theatres of the war and could be classified
as drug prophylaxis and treatment , mosquito
deterrents , personal protection ,or mosquito
Destruction .
Personal prophylaxis with quinine
Was chaotic with weak understanding of
medicines in management ,problems in
drug delivery due to night operations ,enemy
bombs and attacks .
The British questioned the use of
quinine for prevention and place more
emphasis on preventing contact with
mosquitoes.
Personal anti --mosquito ointments
were messy and head nets and Gloves were
Very restrictive especially in active combat.
In the UK during 1916 the total
Issue of quinine exceeds 25tons or
66million 5-gr doses.
Quinine prophylaxis was defined
BY Ross as treatment of persons who have
not yet shown signs of illness but may possibly
Become infected.
Ref Malaria J 2014 :13 :497
Published on line 2014 Dec
16doi :10.1186/1475-2875-13-497
