As oil and gas industry employees are located in sub-Sahara African countries and other areas where malaria is endemic, non-immune workers need to adopt multiple strategies to prevent contracting this potentially fatal disease. Awareness training, personal protection against mosquito bites and vector control measures are all important in reducing Anopheles mosquito bites.

In addition, the prevention of malaria in non-immune individuals relies heavily on the proper use of effective anti-malarial medications, i.e., chemoprophylactic agents. In spite of implementing a comprehensive Malaria Control Program (MCP) and contractually requiring its contractors to implement similarly effective programs for their employees, ExxonMobil affiliates and projects (ExxonMobil) continued to experience Falciparum malaria cases among contractors' non-immune employees assigned to ExxonMobil, including two fatalities.

A multidisciplinary team was formed to identify opportunities to enhance the effectiveness of the MCP. One of the team's key recommendations was to develop and implement a Malaria Chemoprophylaxis Compliance Program (MCCP) to address identified malaria chemoprophylaxis use shortcomings.

At the heart of the MCCP is the random, unannounced acquisition of urine specimens from non-immune individuals for laboratory verification of the presence of an effective anti-malaria medication. Novel laboratory analytical methods were developed and validated, and forensic-type chain of custody specimen handling procedures were adopted. Individuals producing non-conforming specimens are subjected to a confidential medical review process to determine their ongoing fitness-for-duty in malarial areas. The MCCP was implemented in Chad and Cameroon, then in Angola, Equatorial Guinea and Nigeria. As other countries with ExxonMobil employees and contractors working in upstream and downstream operations are added to the MCCP, it is becoming clear that malaria prevention should be treated like other safety initiatives.

Traditionally, employees are issued properly fitted respirators and hard hats to prevent injuries and diseases from hazardous exposures. To be effective, employees need to be educated in the proper use of these PPEs and self-motivated to use them. Likewise, managers must ensure that employees traveling to malarial areas are issued appropriate chemoprophylactic agents and educated in their proper use. Employees need to be motivated and willing to use the medications as prescribed for optimal program results.

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