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Malaria after international travel: a GeoSentinel analysis, 2003-2016.
Malar J. 2017 07 20; 16(1):293.MJ

Abstract

BACKGROUND

More 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.

METHODS

Records 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.

RESULTS

There 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.

CONCLUSION

Malaria 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.

Authors+Show Affiliations

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA, 30329, USA. kangelo@cdc.gov.McGill University Centre for Tropical Diseases, Montreal, Canada.Service des Maladies Infectieuses et Tropicales, GH Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France.Department of Global Health and Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA.Tropical Disease Unit, University of Toronto, Toronto, Canada.Victorian Infectious Diseases Service, Royal Melbourne Hospital, Victoria, Australia. School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.Center for Tropical and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, NY, USA.Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA, 30329, USA. Department of Medicine, Emory University, Atlanta, GA, USA.Liverpool School of Tropical Medicine, Liverpool, UK.Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA, 30329, USA.Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Aix Marseille Université, Tropical IHU-Méditerranée Infection, Marseillle, France.Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy.Geneva University Hospital, Geneva, Switzerland.Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA, 30329, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

28728595

Citation

Angelo, Kristina M., et al. "Malaria After International Travel: a GeoSentinel Analysis, 2003-2016." Malaria Journal, vol. 16, no. 1, 2017, p. 293.
Angelo KM, Libman M, Caumes E, et al. Malaria after international travel: a GeoSentinel analysis, 2003-2016. Malar J. 2017;16(1):293.
Angelo, K. M., Libman, M., Caumes, E., Hamer, D. H., Kain, K. C., Leder, K., Grobusch, M. P., Hagmann, S. H., Kozarsky, P., Lalloo, D. G., Lim, P. L., Patimeteeporn, C., Gautret, P., Odolini, S., Chappuis, F., & Esposito, D. H. (2017). Malaria after international travel: a GeoSentinel analysis, 2003-2016. Malaria Journal, 16(1), 293. https://doi.org/10.1186/s12936-017-1936-3
Angelo KM, et al. Malaria After International Travel: a GeoSentinel Analysis, 2003-2016. Malar J. 2017 07 20;16(1):293. PubMed PMID: 28728595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Malaria after international travel: a GeoSentinel analysis, 2003-2016. AU - Angelo,Kristina M, AU - Libman,Michael, AU - Caumes,Eric, AU - Hamer,Davidson H, AU - Kain,Kevin C, AU - Leder,Karin, AU - Grobusch,Martin P, AU - Hagmann,Stefan H, AU - Kozarsky,Phyllis, AU - Lalloo,David G, AU - Lim,Poh-Lian, AU - Patimeteeporn,Calvin, AU - Gautret,Philippe, AU - Odolini,Silvia, AU - Chappuis,François, AU - Esposito,Douglas H, AU - ,, Y1 - 2017/07/20/ PY - 2017/05/23/received PY - 2017/07/13/accepted PY - 2017/7/22/entrez PY - 2017/7/22/pubmed PY - 2018/5/9/medline KW - GeoSentinel KW - International travel KW - Malaria KW - Plasmodium spp SP - 293 EP - 293 JF - Malaria journal JO - Malar. J. VL - 16 IS - 1 N2 - BACKGROUND: More 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. METHODS: Records 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. RESULTS: There 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. CONCLUSION: Malaria 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. SN - 1475-2875 UR - https://www.unboundmedicine.com/medline/citation/28728595/full_citation L2 - https://malariajournal.biomedcentral.com/articles/10.1186/s12936-017-1936-3 DB - PRIME DP - Unbound Medicine ER -