Background
Methods
Study design and inclusion criteria
Data collection
Statistical methods
Results
Study population
Comp | Country of the mission | Mission dates (MM/YY) | Type of the mission | Nb of soldiers | Nb of men | Age: median (25%-75% quantile) | Nb of soldiers with correct compliance | Nb of clinical malaria attacks | |
---|---|---|---|---|---|---|---|---|---|
Start | End | ||||||||
1 | Ivory Coast | 02/04 | 06/04 | Operation | 144 | 143 | 26 (25 - 29) | 51 (35.4%) | 3 |
2 | CAR | 02/05 | 05/05 | Operation | 115 | 115 | 26 (23 - 29) | 53 (46.1%) | 2 |
3 | Ivory Coast | 02/05 | 05/05 | Operation | 108 | 108 | 22 (21 - 26) | 70 (64.8%) | 1 |
4 | Ivory Coast | 02/05 | 05/05 | Operation | 95 | 95 | 22 (20 - 24) | 55 (57.9%) | 0 |
5 | Ivory Coast | 02/05 | 05/05 | Operation | 73 | 72 | 23 (22 - 26) | 38 (52.1%) | 1 |
6 | Senegal | 06/05 | 09/05 | Training | 133 | 132 | 26 (22 - 30) | 16 (12%) | 0 |
7 | Ivory Coast | 06/08 | 09/05 | Operation | 84 | 84 | 25 (22 - 28.5) | 54 (64.3%) | 0 |
8 | Ivory Coast | 06/08 | 09/05 | Operation | 72 | 66 | 24 (22.5 - 28.5) | 44 (61.1%) | 1 |
9 | Chad | 10/05 | 01/06 | Operation | 134 | 130 | 24 (21 - 27) | 85 (63.4%) | 2 |
10 | Senegal | 02/06 | 05/06 | Training | 102 | 100 | 25 (22 - 28) | 16 (15.7%) | 0 |
11 | Chad | 02/06 | 05/06 | Operation | 83 | 78 | 25 (22 - 29) | 44 (53.0%) | 1 |
12 | Gabon | 07/06 | 11/06 | Training | 94 | 94 | 23.5 (21- 29) | 9 (9.6%) | 1 |
13 | Gabon | 07/06 | 11/06 | Training | 114 | 114 | 24 (21 - 29) | 12 (10.5%) | 2 |
14 | Chad | 06/06 | 09/06 | Operation | 189 | 185 | 24 (21 - 29) | 130 (68.8%) | 0 |
15 | Gabon | 12/06 | 04/07 | Training | 125 | 123 | 25 (22 - 30) | 49 (39.2%) | 0 |
16 | Gabon | 12/06 | 04/07 | Training | 135 | 133 | 24 (22 - 31) | 38 (28.1%) | 1 |
17 | CAR | 06/07 | 09/07 | Operation | 102 | 102 | 23 (20 - 29) | 78 (76.5%) | 0 |
18 | Ivory Coast | 06/07 | 09/07 | Operation | 94 | 92 | 22 (20 - 25) | 72 (76.6%) | 1 |
19 | Ivory Coast | 06/07 | 09/07 | Operation | 97 | 96 | 23 (21 - 28) | 53 (54.6%) | 1 |
Total | 02/04 | 09/07 | 2093 | 2062 | 24 (21 - 28) | 967 (46.2%) | 17 |
Compliance with the chemoprophylaxis
N | N-CC | Prevalence of CC | ||||
---|---|---|---|---|---|---|
% (95% CI)
|
OR
|
95% CI
|
p value
| |||
Type of the mission | < 0.001 | |||||
Training | 703 | 140 | 19.9 (10.0 - 29.8) | 1 | ||
Military operation | 1390 | 827 | 59.5 (51.8 - 67.2) | 6.17 | 3.36 - 11.32 | |
Duration of the mission (mo) | 0.81 | 0.61 - 1.07 | 0.1313 | |||
Age | 0.2150 | |||||
18 - 24 y. | 1071 | 503 | 47.0 (34.9 - 59.1) | 1 | ||
25 y. and more | 1022 | 464 | 45.4 (34.115 - 56.4) | 1.11 | 0.94 - 1.30 | |
Gender | 0.3667 | |||||
Men | 2062 | 953 | 46.2 (34.8 - 57.6) | 1 | ||
Women | 31 | 14 | 45.2 (29.6 - 60.7) | 0.74 | 0.38 - 1.4 | |
Rank | 0.0329 | |||||
JRs - NCOs | 1610 | 728 | 45.2 (33.9 - 56.6) | 1 | ||
Os - WOs | 483 | 239 | 49.5 (37.7 - 61.3) | 1.22 | 1.02 - 1.47 | |
Favorite time for activities | 0.0097 | |||||
Morning type | 531 | 252 | 47.5 (35.0 - 59.9) | 1 | ||
Intermediate type | 1248 | 585 | 46.9 (35.3 - 58.5) | 0.83 | 0.69 - 1.00 | |
Evening type | 314 | 130 | 41.4 (30.1 - 52.7) | 0.68 | 0.52 - 0.87 | |
Bedtime during the mission | 0.0033 | |||||
Before or at midnight | 1607 | 778 | 48.4 (35.7 - 61.1) | 1 | ||
After midnight | 342 | 138 | 40.4 (30.0 - 50.7) | 0.69 | 0.55 - 0.86 | |
NA (Company 1) | 144 | 51 | 35.4 (27.5 - 43.3) | 0.57 | 0.09 - 3.56 | |
Previous overseas travel | 0.1778 | |||||
No | 435 | 244 | 56.1 (44.7 - 67.5) | 1 | ||
Yes | 1658 | 723 | 43.6 (32.3 - 54.9) | 0.87 | 0.72 - 1.06 | |
Tobacco consumption | 0.0420 | |||||
Nonsmoker | 934 | 451 | 48.3 (36.2 - 60.4) | 1 | ||
Smoker 1-20 cig/d. | 903 | 406 | 45.0 (33.0 - 56.9) | 0.86 | 0.73 - 1.02 | |
Smoker >20 cig/d. | 256 | 110 | 43.0 (32.3 - 53.7) | 0.75 | 0.58- 0.96 |
N | N-CC | Prevalence of CC | ||||
---|---|---|---|---|---|---|
% (95% CI)
|
OR
|
95% CI
|
p value
| |||
Birth of a child | 0.1168 | |||||
No | 2040 | 941 | 46.1 (35.0 - 57.3) | 1 | ||
Yes | 53 | 26 | 49.1 (29.4 - 68.7) | 1.49 | 0.91 - 2.46 | |
Death of a relative or a friend | 0.5877 | |||||
No | 2004 | 928 | 46.3 (35.1 - 57.5) | 1 | ||
Yes | 89 | 39 | 43.8 (27.1 - 60.6) | 1.11 | 0.76 - 1.63 | |
Disease of a relative or a friend | 0.9812 | |||||
No | 1996 | 926 | 46.4 (35.0 - 57.8) | 1 | ||
Yes | 97 | 41 | 42.3 (30.3 - 54.2) | 1 | 0.69 - 1.44 | |
Announcement of a separation or a divorce | 0.2850 | |||||
No | 2048 | 943 | 46.0 (34.7 - 57.4) | 1 | ||
Yes | 45 | 24 | 53.3 (32.4 - 74.3) | 1.34 | 0.78 - 2.29 | |
Perception of a dangerous situation | 0.2358 | |||||
No | 2041 | 947 | 46.4 (35.0 - 57.8) | 1 | ||
Yes | 52 | 20 | 38.5 (23.8 - 53.1) | 0.73 | 0.44 - 1.23 | |
Perception of personal malaria risk compared to other soldiers | 0.4728 | |||||
Inferior | 280 | 132 | 47.1 (34.3 - 60.0) | 1 | ||
Equivalent | 1388 | 644 | 46.4 (34.3 - 58.5) | 1.04 | 0.82 - 1.32 | |
Superior | 425 | 191 | 45.0 (33.1 - 56.8) | 0.92 | 0.70 - 1.21 | |
Perception of the severity of malaria | 0.0295 | |||||
Not severe | 254 | 136 | 53.5 (42.7 - 64.4) | 1.3 | 1.02 - 1.66 | |
Mildly severe | 1473 | 654 | 44.4 (32.4 - 56.4) | 1 | ||
Very severe | 366 | 177 | 48.4 (35.1 - 61.6) | 1.22 | 0.99 - 1.51 | |
Perceived mosquito attractiveness compared to other soldiers | 0.0024 | |||||
Inferior to the others | 608 | 275 | 45.2 (32.1 - 58.3) | 0.77 | 0.64 - 0.93 | |
Equivalent to the others | 998 | 490 | 49.1 (38.3 - 59.9) | 1 | ||
Superior to the others | 487 | 202 | 41.5 (29.0 - 53.9) | 0.75 | 0.61 - 0.91 |
N | N-CC | Prevalence of CC | ||||
---|---|---|---|---|---|---|
% (95% CI)
|
OR
|
95% CI
|
p value
| |||
Condition of the received bed net | 0.0502 | |||||
Bad condition | 736 | 338 | 45.9 (32.3 - 59.5) | 1 | ||
Good condition | 1145 | 543 | 47.4 (36.0 - 58.9) | 1.19 | 1.00 - 1.42 | |
NA: Company 1 or no net received | 212 | 86 | 40.6 (25.9 - 55.2) | - | - | |
Use of repellents before bedtime | 0.0144 | |||||
Not always | 2019 | 919 | 45.5 (34.4 - 56.6) | 1 | ||
Always | 74 | 48 | 64.9 (45.0 - 84.8) | 1.73 | 1.11 - 2.67 | |
Use of insecticides for clothes before bedtime | 0.0592 | |||||
Not always | 1922 | 894 | 46.5 (34.5 - 58.5) | 1 | ||
Always | 27 | 22 | 81.5 (71.4 - 91.6) | 2.46 | 1.15 - 5.28 | |
NA (Company 1) | 144 | 51 | 35.4 (27.5 - 43.3) | 0.62 | 0.10 - 3.80 | |
Long clothes worn before bedtime | 0.0026 | |||||
Not always | 1025 | 384 | 37.5 (22.7 - 52.2) | 1 | ||
Always | 1068 | 583 | 54.6 (46.4 - 62.8) | 1.33 | 1.11 - 1.61 | |
Use of a bed net during sleep | < 0.0001 | |||||
Not always | 981 | 411 | 41.9 (26.1 - 57.7) | 1 | ||
Always | 1112 | 566 | 50.0 (37.9 - 62.1) | 1.57 | 1.28 - 1.94 | |
Systematic use of protective measures: long clothes, repellents, and bed net | < 0.0001 | |||||
No one | 653 | 249 | 38.1 (21.4 - 54.9) | 1 | ||
One of them | 671 | 277 | 41.3 (26.8 - 55.8) | 1.31 | 1.05 - 1.63 | |
Two or three of them | 769 | 441 | 57.4 (48.0 - 66.7) | 2.03 | 1.56 - 2.65 |
N | N-CC | Prevalence of CC | ||||
---|---|---|---|---|---|---|
% (95% CI)
|
OR
|
95% CI
|
p value
| |||
Drug prescribed | 0.0592 | |||||
Chloroquine - proguanil | 409 | 259 | 63.3 (55.3 - 71.4) | 1 | ||
Doxycycline | 1675 | 701 | 41.9 (29.9 - 53.8) | 0.65 | 0.34 - 1.26 | |
Mefloquine or other | 9 | 7 | 77. 8 (46.9 - 100.0) | 2.9 | 0.58 - 14.44 | |
Tolerance to the intake | 0.1077 | |||||
Rather bad to very bad | 173 | 64 | 37.0 (18.4 - 55.6) | 1 | ||
Rather good | 1010 | 442 | 43.8 (32.7 - 54.9) | 1 | 0.74 - 1.35 | |
Very good | 910 | 461 | 50.7 (39.7 - 61.7) | 1.19 | 0.88 - 1.61 | |
Regularity of the day time of the intake | 0.0419 | |||||
Rather at the same time | 1622 | 826 | 50.9 (40.1 - 61.8) | 1 | ||
Rather at different times | 327 | 90 | 27.5 (14.9 - 40.2) | 0.75 | 0.59 - 0.94 | |
NA (Company 1) | 144 | 51 | 35.4 (27.5 - 43.3) | 0.58 | 0.10 - 3.44 |
N | N-CC | Prevalence of CC | ||||
---|---|---|---|---|---|---|
% (95% CI)
|
OR
|
95% CI
|
p value
| |||
Medical history of malaria | 0.0002 | |||||
No | 1870 | 902 | 48.2 (37.0 - 59.5) | 1 | ||
Yes | 180 | 50 | 27.8 (17.2 - 38.4) | 0.59 | 0.44 - 0.79 | |
Does not know | 43 | 15 | 34.9 (18.6 - 51.1) | 0.51 | 0.28 - 0.91 | |
Medical history of dengue fever | 0.0625 | |||||
No | 1961 | 921 | 46.97 (35.7 - 58.3) | 1 | ||
Yes | 83 | 26 | 31.32 (19.3 - 43.3) | 0.66 | 0.44 - 1.00 | |
Does not know | 49 | 20 | 40.82 (22.0 - 59.7) | 0.69 | 0.40 - 1.16 | |
Occurrence of a disease during the mission | 0.1223 | |||||
No | 1177 | 540 | 45.9 (34.2 - 57.6) | 1 | ||
Yes | 916 | 427 | 46.6 (34.5 - 58.8) | 0.88 | 0.74 - 1.04 | |
Occurrence of clinical malaria during the mission | 0.0074 | |||||
No | 2076 | 965 | 46.5 (35.2 - 57.8) | 1 | ||
Yes | 17 | 2 | 11.8 (3.6 - 27.1) | 0.18 | 0.05 - 0.63 |
N | N-CC | RE | |||
---|---|---|---|---|---|
aOR
|
IC 95%
|
p-value
| |||
Type of the mission | < 0.0001 | ||||
Training | 703 | 140 | 1.00 | ||
Military operation | 1390 | 827 | 6.46 | 3.92 - 10.65 | |
Preferred time for activities | 0.0805 | ||||
Morning type | 531 | 252 | 1.00 | ||
Intermediate type | 1248 | 585 | 0.83 | 0.65 - 1.05 | |
Evening type | 314 | 530 | 0.69 | 0.50 - 0.96 | |
Bedtime during the mission | < 0.0001 | ||||
Before or at midnight | 1607 | 778 | 1.00 | ||
After midnight | 342 | 138 | 0.73 | 0.56 - 0.96 | |
Not Available (Company 1) | 144 | 51 | 0.30 | 0.17 - 0.52 | |
Birth of a child | 0.0421 | ||||
No | 2040 | 941 | 1.00 | ||
Yes | 53 | 26 | 1.99 | 1.02 - 3.88 | |
Perception of the severity of malaria | 0.0171 | ||||
Not severe | 254 | 136 | 1.44 | 1.06 - 1.96 | |
Mildly severe | 1473 | 654 | 1.00 | ||
Very severe | 366 | 177 | 1.31 | 1.00 - 1.71 | |
Systematic use of protective measures: long clothes, repellents, and bed net | 0.0001 | ||||
No one | 653 | 249 | 1.00 | ||
One of them | 671 | 277 | 1.39 | 1.03 - 1.87 | |
Two or three of them | 769 | 441 | 2.12 | 1.49 - 3.01 | |
Medical history of clinical malaria | < 0.0001 | ||||
No | 1870 | 902 | 1.00 | ||
Yes | 180 | 50 | 0.45 | 0.30 - 0.66 | |
Does not know | 43 | 15 | 0.44 | 0.22 - 0.87 | |
Perceived mosquito attractiveness, compared to other soldiers | 0.0029 | ||||
Inferior to the others | 608 | 275 | 0.71 | 0.56 - 0.89 | |
Equivalent to the others | 998 | 490 | 1.00 | ||
Superior to the others | 487 | 202 | 0.71 | 0.55 - 0.91 | |
Random effect (i.e. company effect) | < 0.0001 |