Malaria outbreak investigation, first infantry brigade. Flores, Peten. Guatemala, October 2021

Background
Seventy-four percent of Guatemala’s territory (108,880 km2) is considered a malarious area, a public health problem. The northern region has a higher incidence of 7.3 cases/100,000 inhabitants, due to climate, ecology, topography, internal and external migration. In October 2012, an increase in febrile cases was reported in the northern Petén health area, in military infantry brigades, reporting febrile persons with recurrent malaria diagnosis. The objective was to determine the existence of the outbreak, describe it in time, place and person and initiate control and prevention measures.
Methods
Descriptive study of outbreak investigation, conducting interviews with epidemiological record, taking thick drop to suspects, residents with symptoms: fever, chills, headache and malaise, between September-October 2021; those confirmed were defined with positive diagnosis to Plasmodium. Data source: Population census, larval survey, physical-chemical control of mosquitoes. Treatment was provided to confirmed cases with epidemiological follow-up, sketch elaboration. We calculated and analyzed average, age range, proportions and attack rates.
Results
Military population 910, 508 interviewed and sampled, 17 confirmed to P. vivax, all men. Mean age 21 years, range 18-60 years, 17(100%) patients presented fever and chills, one of those confirmed with a history of malaria, two with abandonment of the first treatment, average of seeking medical attention 6.43 days, 17(100%) did not use flag, repellent and protective clothing, 15(88.2%) are recruits of the military training course. 16 (94.1%) were within 50m of positive vector breeding sites. The epidemic curve indicates a spread behavior of the outbreak, attack rate 1.87% (17/910).
Conclusion
A total of 378 long-lasting insecticidal nets (LLINs) were installed on military beds and medicines controlled the outbreak. Health areas and nearby residences were notified for prevention, and epidemiological, entomological and health education surveillance on malaria continued after the outbreak.

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