Malaria after international travel: A GeoSentinel analysis, 2003-2016

Kristina M. Angelo, Michael Libman, Eric Caumes, Davidson H. Hamer, Kevin C. Kain, Karin Leder, Martin P. Grobusch, Stefan H. Hagmann, Phyllis Kozarsky, David G. Lalloo, Poh Lian Lim, Calvin Patimeteeporn, Philippe Gautret, Silvia Odolini, François Chappuis, Douglas H. Esposito, Emilie Javelle, Francesco Castelli, Alberto Matteelli, Alice PerignonCamilla Rothe, Christoph Rapp, Cecile Ficko, Eli Schwartz, Frank Von Sonnenburg, Watcharapong Piyaphanee, Udomsak Silachamroon, Andrea Boggild, Perry Van Genderen, Joe Torresi, Mogens Jensenius, Shuzo Kanagawa, Yasuyuki Kato, Cedric Yansouni, Anne McCarthy, Paul Kelly, Bram Goorhuis, Rogelio López-Vélez, Francesco Norman, Marc Mendelson, Peter Vincent, Effrossyni Gkrania-Klotsas, Ben Warne, Denis Malvy, Alexandre Duvignaud, Emanuel Bottieau, Joannes Clerinx, Christina Coyle, Hilmer Àsgeirsson, Hedvig Glans, Patricia Schlagenhauf, Rainer Weber, Frank Mockenhaupt, Gundel Harms-Zwingenberger, Nicholas Beeching, Jan Hajek, Wayne Ghesquiere, Henry Wu, Elizabeth Barnett, Natasha Hockberg, Yukiriro Yoshimura, Natsuo Tachikawa, John Cahill, George McKinley, William Stauffer, Pat Walker, Susan Kuhn, Lin Chen, Daniel Leung, Scott Benson, Carsten Schade Larsen, Christian Wejse, Vanessa Field, Carmelo Licitra, Alena Klochko, Noreen Hynes, Cecilia Perret Perez, Bradley Connor, Holly Murphy, Prativa Pandey, Jean Vincelette, Sapha Barkati, Simin Aysel Florescu, Corneliu Petru Popescu, Lucille Blumberg, Albie De Frey, Susan Anderson, Marc Shaw, Annemarie Hern, Israel Molina, Johnnie Yates, Hugo Siu, Luis Manuel Valdez, Jean Haulman, David Roesel, Phi Truong Hoang Phu, Sarah Borwein

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article number293
JournalMalaria journal
Volume16
Issue number1
DOIs
StatePublished - Jul 20 2017

Keywords

  • GeoSentinel
  • International travel
  • Malaria
  • Plasmodium spp

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

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    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., Javelle, E., Castelli, F., Matteelli, A., ... Borwein, S. (2017). Malaria after international travel: A GeoSentinel analysis, 2003-2016. Malaria journal, 16(1), [293]. https://doi.org/10.1186/s12936-017-1936-3