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Geographical Origin of Post-Landmine Injury Malaria Infections

Published online by Cambridge University Press:  08 October 2014

Jo Durham ,
Katherine Battle ,
Keith Rickart  and
G. Dennis Shanks
Jo Durham*
Affiliation:
University of Queensland, School of Population Health, Herston, Brisbane, Australia
Katherine Battle
Affiliation:
University of Oxford, Department of Zoology, Malaria Atlas Project, Oxford, England.
Keith Rickart
Affiliation:
Health Department, Communicable Disease Unit, Brisbane, Australia
G. Dennis Shanks
Affiliation:
Australian Army Malaria Institute, Brisbane, Australia
*
Correspondence and reprint requests to Jo Durham, PhD, University of Queensland, School of Population Health, Herston Road, Herston, Queensland, Australia 4006 (E-mail: m.durham@uq.edu.au).
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Abstract

Objective

In Cambodia, a highly landmine-contaminated country with endemic malaria, symptomatic falciparum malaria has been observed in patients presenting with traumatic landmine injuries. Because a link between recrudescence of symptomatic Plasmodium falciparum malaria and severe trauma is well established, we explored whether a link could be demonstrated between the geolocation of landmine amputations and malaria cases.

Method

Landmine amputation data in Cambodia (2005–2008) were compared with predicted measures of malaria endemicity. Data of injuries that had resulted in amputation were plotted over a surface of P falciparum parasite rates.

Results

No statistically significant correlation was found, possibly because the P falciparum endemicity surface was drawn from a model-based geostatistical prediction of infection prevalence and did not distinguish cases of recrudescence. The implication of this finding is that where symptomatic falciparum malaria has been observed in patients with landmine injuries, the cases were likely to be reactivated falciparum infections and not new cases.

Conclusions

Further research is needed to understand the relationship between P falciparum and trauma. To distinguish P falciparum recrudescence from new cases, a prospective registry is needed. Also, practitioners need to be aware of the possibility of post-injury malaria recrudescence in complex emergencies. (Disaster Med Public Health Preparedness. 2014;0:1-5)

Keywords

CambodialandminesP falciparum malariarecrudescencewardisaster medicineamputation
Type
Brief Report
Information
Disaster Medicine and Public Health Preparedness , Volume 8 , Issue 5 , October 2014 , pp. 417 - 421
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

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