STUTTGART, Germany – As the U.S. military mission in Africa grows, more troops will face potential infection with deadly strains of malaria, prompting medical officials to ramp up programs aimed at bolstering awareness and prevention, according to Africa Command’s top doctor.

Saving a life might be as basic as swallowing a daily pill, using bed nets and applying mosquito repellent, but ensuring compliance in the field isn’t always easy.

“There are challenges every step of the way,” said AFRICOM surgeon Col. Robert Miller. “It’s a leadership challenge, and it is an individual responsibility.”

On Wednesday, U.S. military and medical officials met with counterparts from several nations as part of AFRICOM’s first “Malaria Symposium,” which focused on the challenges of operating in territory where malaria is an everyday threat. The three-day conference in Stuttgart brought together military medical specialists from Tanzania, Benin, Senegal, Uganda and Kenya, as well as several U.S. military and health agencies.

For AFRICOM, the focus on malaria cuts two ways. While the command first must ensure that the troops it sends to the continent are educated on preventing infection, AFRICOM also is looking at ways it can provide assistance to its partners who routinely face malaria infection. Access to better health care, within both the general population and the military, helps promote stability on the continent, Miller said.

Roughly 90 percent of the more than 1 million malaria-related deaths each year are in Africa, and the soldiers there face unique risks. In Ghana, one of the more advanced and better-funded militaries, malaria is the No. 1 cause of death among troops, representing 30 percent of casualties, according to Lt. Cmdr. E.O. Nyako, a health official with the Ghana armed forces.

One risk factor, he said, is peacekeeping missions that take soldiers far from home and expose them to strains to which they appear to have little resistance.

In addition, Nyako said Ghana’s military doesn’t have the resources to maintain robust surveillance and intervention programs when troops deploy to places such as the Democratic Republic of the Congo or Liberia. That concern was echoed by officials from other African countries at the symposium in Stuttgart.

In 2010, 24 U.S. troops contracted the disease in Africa — the second highest number since 2002 and a direct result of increased exposure, according to U.S. military medical officials. Unlike their African counterparts, U.S. troops have little or no immunity to malaria. For that reason, it is all the more important that troops are diligent about preventive measures, Miller said.

“Sometimes people get a false sense of security,” Miller said.

That appeared to be the case in 2009 when 23-year-old Navy Seabee Joshua Dae Ho Carrell died after becoming infected with malaria during a mission in Liberia. A military investigation of the death revealed that the sailor failed to regularly take anti-malarial medication and that the unit failed to ensure that personal protective measures such as proper uniform-wearing and application of the insecticide DEET were followed.

The Carrell case should serve as a reminder to all troops about the risks, Miller said.

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John covers U.S. military activities across Europe and Africa. Based in Stuttgart, Germany, he previously worked for newspapers in New Jersey, North Carolina and Maryland. He is a graduate of the University of Delaware.

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