Malaria Epidemics in Refugees During Armed Conflict.

Refugees displaced from their usual residence by military conflict may generate malaria epidemics when moving into endemic areas. Examples from the 1980s include Khmer refugees from Cambodia into Thailand and Afghan refugees from Afghanistan into Pakistan. In both cases, civilians with little malaria experience were exposed to both P. vivax and P. falciparum malaria. After military coups, Burmese refugees from Myanmar to Thailand also experienced malaria epidemics when coming from non-endemic areas. When Papuan refugees from Indonesia fled into Papua New Guinea, little malaria resulted as there was malaria on both sides of the international border. However, later transmigrants from Java to Papua experienced lethal malaria epidemics. Previous immunity, access to medical care and ecological disruption promoting mosquito vectors all contribute to a composite malaria epidemic risk. Those conducting humanitarian assistance missions need to be alert to the possibility of malaria outbreaks in refugee populations. [ABSTRACT FROM AUTHOR]