Malaria’s contribution to World War One – the unexpected adversary

Brabin, Bernard J

doi:10.1186/1475-2875-13-497

Malaria Journal

Table 1 Military malaria surveillance statistics 1914 – 1918

From: Malaria’s contribution to World War One – the unexpected adversary

Military forces	Location	Years	Military case (n) and incidence estimates	Military deaths (n)	Case fatality, %	Military population exposed (n)	Malaria species^a	References
Europe and Middle East
British	Macedonia and Salonika plain	1916 (Oct) -1918	162,517, 369 per 1000^c	787	0.2-0.48	404,207^b – 549,111	Mostly Pv	[16], ([2] p2, p80),
British	Macedonia and Salonika plain	1916 (Oct) -1918	162,517, 369 per 1000^c	787	0.2-0.48	British, French 150,000, Serbs 200,000		[1, 17]
French	Macedonia	1916–1917	66,271	667	2.10^d			[18–21]
British	North Russia	1918–1919	35, 8.7 per 1000, 32,688	?		22,258	Pv, Pf	([2] p2,p80)
German, Bulgarian	Balkans	1915–1918	113 per 1000		--	380,000 - 462,000	Pv	[22, 23]
	Macedonia	1916-1917	21,672	?	0.92	--	Mostly Pv Pf, Pm Pv, Pf	[19, 22]
British, French	Italy	1917-1918	7373 (40% relapses)	?	--	145,764 - 210,943	Pv, Pf	([2] p2,p80),
Italian		1915-1918	Many thousands	?	0.03-1.3			[6, 12]
Australian Desert Mounted Corps	Palestine	1918 (May-Dec)	Of 19,652 illnesses, 6,347 slide positive			40,000	Mostly Pf	[24]
	Palestine	1918 (Sept-Oct)	1940	98	5.05^e			[24]
British & Dominion	Egypt and Palestine	1914–1918	40,144	854 ^f	2.13	1,192,511	Pv, Pf	([2] p80), [24]
British	Palestine	1918 (Apr-Sept)	7,270			70,000		[25]
Turkish	Ottoman territory	1914-1918	412,000 - 461,799	20,000 -23,351	4.8	350,000	Pv, Pf	[26, 27]
German	Ottoman territory	1915-July 1918	4,763, 308 per 1000	?	--	5540		[22], ([28] p231)
German	Dardanelles	Apr 1915-Jan 1916	200 per 1000^g	?	--	1000		([28] p231), [29]
Mixed allied force	Mesopotamia	1914-1918	59,323	284 ^h	0.76	889,702 – 969,388	Mostly Pv	([2] p2 p80)
	Kuwait, Nasiriya	1915–1917	1,365, main admission	?	--	468,987 - 489,000		[10]
	Dardanelles	Apr 1915-Jan 1916	1,473	5	0.34			[1], ([2] p80)
Western Front: Allied & United States	North-East France and Belgium	1914-1918	9,022, outbreaks of <20	14	0.16	5,399,563 - 6,843,563	Mostly Pv	([30] p75,p115), ([2] p80), [31], ([32] p439-441)
Western Front: German		1914-1918	11,222, <1 per 1000	?	--	5,200,000	Pv, Pf	[22], ([32] p439), [33]
Eastern Front Allied: Russian, Romanian	Russia, Romania, Armenia, Georgia. Anatolia, Albania	1915-1916	Albanian armies suffered severely from malaria	?	--	525,000 ⁱ	Pv, Pf, Pm	([30], p153),
Eastern Front Allied: Russian, Romanian	Russia, Romania, Armenia, Georgia. Anatolia, Albania	1915-1916	Albanian armies suffered severely from malaria	?	--	525,000 ⁱ	Pv, Pf, Pm	[21, 34, 35]
Eastern Front Axis: German	Galicia and Anatolia	1914–1918	29,952	?	? ^k	228,000 – 750,000^j		[22, 28] p137, [35]
Eastern Front Axis: German	Galicia and Anatolia	1914–1918	5.1 per 1000	?	? ^k	228,000 – 750,000^j		[22, 28] p137, [35]
Turkish, Austro-Hungarian	Yugoslavia	1917-1918	128 per 1000	?	--	270,000 – 1,045,050		([30] p47), ([36] p399)
Evacuations to England from Europe and Africa	UK	1917-1918	34,000, 500 local cases in Southern England	323	0.95	≥34,000	Pv, Pf	([17] p140), [37]
Outside Europe and Middle East
British expeditionary	East Africa, Kenya, Tanganyika	1915-1918	145,850 troops and 68,914 indigenous, 51.000 hospitalized, 126 per 1000(troops), 20 per 1000 (others)	831 troops with 2839 indigenous	0.57	250,000 British (75,366) and indigenous with 150,000 Indian	Mostly Pf	[2] p2, p80, [39]
British expeditionary	East Africa, Kenya, Tanganyika	1915-1918		831 troops with 2839 indigenous	4.12	250,000 British (75,366) and indigenous with 150,000 Indian	Mostly Pf	[2] p2, p80, [39]
	South-West Africa	1914–1915	518	2	0.39	33,000	Mostly Pf	([2] p2, p80)
	Cameroon	1915–1916	2410	5	0.21	3000	Pf	[14, 40]
	Sierra Leone	1914	401, 1839 per 1000	? 0	? 0.00	218	Pf	[41]
German expeditionary	Togo, East and South-West Africa	1914-1918	Lower incidence as mostly indigenous forces used	?	--	18,000 ^l, 3000 German troops, remainder indigenous	Mostly Pf	[35, 42]
USA naval	Americas, Caribbean	1917-1918	4,746 hospital cases, 68,373 man-sick days	7	0.15	--	Mixed	[43]

Dashed indicate information not identified, and question mark unknown mortality case numbers.
^aPv: Plasmodium vivax; Pf: Plasmodium falciparum; Pm: Plasmodium malariae.
^bEstimate includes British, French, Serbian, and Russian troops.
^c13.7% in British troops; 27.4% in Indian troops.
^dOf 100 autopsies of influenza pneumonia, 83 showed definite evidence of previous malaria [19].
^eEstimated from graphic data from all cases in Sept-Oct and deaths reported in October [24].
^fDeaths due to P.falciparum infections. Confirmed diagnoses in 32 of 67 autopsies; many complicated by dual infection with influenza bronchopneumonia [44].
^gEstimate for German troops only.
^hDeaths for years 1917–1918 only.
ⁱBrusilov offensive 1915–1916.
^jRusso-Turkish offensive winter 1915 – 1916.
^kOf 2,873,000 men mobilized on the Turkish side in Ottoman territory, approximately 466,759 died of disease [28].
^lEstimate for East African German forces.

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ISSN: 1475-2875

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