Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites. 1. Introduction Malaria is one of the most widespread infectious diseases of our time. According to the latest WHO estimates, there were about 219 million cases of malaria in 2010 and an estimated 660?000 deaths. Africa is the most affected continent: about 90% of all malaria deaths occur there. The last few years were marked by an increasing number of imported malaria supported by the increasing number of international travel in association with the important influx of immigrants from malaria-endemic countries especially from the Sub-Saharan Africa [1]. Malaria burden is difficult to estimate, especially in low-income countries where data collection and reporting quality are poor. Data emerging from WHO reports just estimate malaria incidence and mortality, reporting malarial cases and malarial death from the different WHO regions, collected by ministries of health of different countries. These data do not reflect the real incidence in the general population [2]. In Tunisia, we declare currently between 40 and 50 annual cases of imported malaria. Plasmodium falciparum is the origin of the majority of the cases [3, 4]. Soldiers are no exception, as malaria represents a common risk threatening sometimes the vital prognosis in
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