Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers

Malaria Journal

Research

Brechje de Gier¹  Mieke Croughs²  Leo G. Visser³  Franciska S. T. Suryapranata⁴  Gerard J. B. Sonder⁵  Michele van Vugt⁶  Perry J. J. van Genderen⁷  Monique Keuter⁸ 

[1] Department for Early Warning and Surveillance, Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands;Department of Environment, Public Health Service (GGD) Hart voor Brabant, Ringbaan West 227, 5037 PC, Tilburg, The Netherlands;Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Infectious Diseases, Leiden University Medical Centre, C5P46, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, PO Box 2200, Nieuwe Achtergracht 100, 1000 CE, Amsterdam, The Netherlands;National Coordination Centre for Travellers’ Health Advice (LCR), PO Box 1008, Nieuwe Achtergracht 100, 1000 BA, Amsterdam, The Netherlands;Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, PO Box 2200, Nieuwe Achtergracht 100, 1000 CE, Amsterdam, The Netherlands;National Coordination Centre for Travellers’ Health Advice (LCR), PO Box 1008, Nieuwe Achtergracht 100, 1000 BA, Amsterdam, The Netherlands;Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Institute for Tropical Diseases, Harbour Hospital Rotterdam, Haringvliet 72, 3011 TG, Rotterdam, The Netherlands;Nijmegen Institute for International Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;

关键词: Epidemiology;    Surveillance;    Travel;   

DOI  :  10.1186/s12936-017-1711-5

 received in 2016-10-04, accepted in 2017-01-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMalaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012.ResultsA modest increase in overall imported malaria notifications occurred in 2008–2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008–2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008–2012, incidence in tourists visiting Central and West Africa dropped markedly.ConclusionsImported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands.

【 授权许可】

CC BY   
© The Author(s) 2017