Malaria after international travel: a GeoSentinel analysis, 2003–2016

Malaria Journal

Research

Martin P. Grobusch¹  Davidson H. Hamer²  Silvia Odolini³  Douglas H. Esposito⁴  Kristina M. Angelo⁴  Calvin Patimeteeporn⁴  Phyllis Kozarsky⁵  François Chappuis⁶  Poh-Lian Lim⁷  David G. Lalloo⁸  Michael Libman⁹  Eric Caumes^1,10  Stefan H. Hagmann^1,11  Kevin C. Kain^1,12  Philippe Gautret^1,13  Karin Leder^1,14 

[1] Center for Tropical and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands;Department of Global Health and Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA;Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy;Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Mailstop E03, 1600 Clifton Rd NE, 30329, Atlanta, GA, USA;Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Mailstop E03, 1600 Clifton Rd NE, 30329, Atlanta, GA, USA;Department of Medicine, Emory University, Atlanta, GA, USA;Geneva University Hospital, Geneva, Switzerland;Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore;Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore;Liverpool School of Tropical Medicine, Liverpool, UK;McGill University Centre for Tropical Diseases, Montreal, Canada;Service des Maladies Infectieuses et Tropicales, GH Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France;Steven and Alexandra Cohen Children’s Medical Center of New York, New Hyde Park, New York, NY, USA;Tropical Disease Unit, University of Toronto, Toronto, Canada;Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Aix Marseille Université, Tropical IHU-Méditerranée Infection, Marseillle, France;Victorian Infectious Diseases Service, Royal Melbourne Hospital, Victoria, Australia;School of Public Health and Preventive Medicine, Monash University, Victoria, Australia;

关键词: Malaria;    International travel;    Plasmodium;    GeoSentinel;   

DOI  :  10.1186/s12936-017-1936-3

 received in 2017-05-23, accepted in 2017-07-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMore than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation.MethodsRecords with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria.ResultsThere were 5689 travellers included; 325 were children <18 years. More than half (53%) were visiting friends and relatives (VFRs). Most (83%) were exposed in sub-Saharan Africa. The median trip duration was 32 days (interquartile range 20–75); 53% did not have a pre-travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died.ConclusionMalaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized.

【 授权许可】

CC BY   
© The Author(s) 2017