Malaria anticircumsporozoite antibodies in Dutch soldiers returning from sub-Saharan Africa.

One hundred and twenty-five Dutch servicemen returning from central Africa after a short deployment were enrolled in a study aimed at assessing the effectiveness of malaria prevention measures. None of the persons developed an episode of clinically overt malaria during or after deployment, and no antibodies against blood stages of Plasmodium falciparum could be found. However, antibodies against the circumsporozoite protein (CS) of P. falciparum were demonstrable in 14 persons (11.2% of the study population) by an ELISA test using the recombinant CS-antigen R32tet32, while one person only was positive in an IFA test based on schizonts of P. fieldi as antigen. We concluded that the anti-CS-positive servicemen were probably bitten by mosquitoes carrying P. falciparum parasites while the IFA-positive person was possibly infected by P. vivax, P. ovale or P. malariae parasites. There was no significant association between the different antimalaria preventive measures and the development of anti-CS antibodies. Therefore mefloquine prophylaxis as the single most widely used preventive measure in this group of servicemen was possibly a major contributing factor in averting development of overt malaria.

Diarrhea morbidity among Dutch military service men in Goma, Zaire.

An outbreak of diarrheal disease occurring among service men of the Royal Netherlands Forces while serving in the refugee camps in Goma, Zaire, is presented. Post-travel questionnaires were given to 131 military service men returning from Goma. In addition, routine blood investigations were undertaken and stool examined for persons with abdominal complaints. A high prevalence (59%) of diarrheal disease associated with the eating of food served by a local hotel was noted. Fifty percent of persons who developed diarrhea in this period had symptoms persisting for up to 10 days. Pathogens were recovered from the stools of five persons, and four of these had Shigella organisms isolated. The outbreak of diarrhea among the service men was directly linked to the eating of food that was prepared by a local Goma hotel, the possible causative agent for this outbreak being Shigella organisms. Both military and civilian humanitarians working in areas such as refugee camps with a high prevalence of diarrheal diseases should carefully consider eating from local restaurants and hotels.