Malaria among Croatian seafarers between 2004 and 2014: evaluation of chemoprophylaxis use and occupational disease reporting

In Croatia, malaria was eradicated in 1964 and has since been imported, ten cases a year in average, mostly by Croatian migrant workers, seafarers in particular. About 80 % of registered cases were infected in Africa and the main reason for infection was negligence in the use of chemoprophylaxis. The aim of the study was to establish the incidence of malaria among Croatian seafarers from 2004 to 2014, how many of them took chemoprophylaxis properly, and whether malaria was acknowledged as occupational disease. To get our answers we analysed epidemiological surveys of the Croatian Institute of Public Health completed by patients and reviewed epidemiological bulletins and the national Register of Occupational Diseases. Over the investigated period, a total of 102 people fell ill with malaria, of whom 25 were seafarers. Seventeen did not take chemoprophylaxis at all and eight took them without following instructions. In addition, none of them had malaria recognised as occupational disease under Croatian law, nor is there any information that they exercised their rights in any other way. All this clearly points out that seafarers and their employers need to be informed much better about the benefits of preventive measures and their labour rights.