Dataset Information

Epidemiologic Trends in Malaria Incidence Among Travelers Returning to Metropolitan France, 1996-2016.

ABSTRACT:

Importance

Despite annually adapted recommendations to prevent malaria in travelers to endemic areas, France is still the industrialized country reporting the highest number of imported cases of malaria. Better understanding of the epidemiologic context and evolution during the past 2 decades may help to define a better preventive strategy.

Objective

To study epidemiologic trends of imported cases of malaria in travelers in geographic territories of France on the European continent (metropolitan France) from 1996 through 2016 to potentially explain the persistence of high imported malaria incidence despite national preventive measures.

Design, setting, and participants

In a cross-sectional study, between January 1 and May 31, 2018, data were extracted from the French National Reference Center of Malaria Surveillance. Trends in patients with imported malaria in association with age, sex, ethnicity, purpose of travel, malaria species, severity of illness, case mortality rate, and endemic countries visited were analyzed in 43?333 malaria cases among civilian travelers living in metropolitan France.

Main outcomes and measures

Evolution of the main epidemiologic characteristics of patients with imported malaria.

Results

Among the 43?333 patients with imported malaria in civilian travelers included in the study, 24?949 were male (62.4%), and 8549 were younger than 18 years (19.9%). A total of 28?658 malaria cases (71.5%) were among African individuals, and 10?618 cases (26.5%) among European individuals. From 1996 through 2016, the number of confirmed malaria cases peaked at 3400 cases in 2000, then declined to 1824 cases in 2005 and stabilized thereafter to approximately 1720 malaria cases per year. A total of 37?065 cases (85.5%) were due to Plasmodium falciparum. The proportion of malaria cases among African individuals rose from 53.5% in 1996 to 83.4% in 2016, and the most frequent motivation for traveling was visiting friends and relatives (25?329 [77.1%]; P?Conclusions and relevanceBeyond the apparent stability of the number of imported malaria cases in France, significant changes appear to have occurred among the population who developed malaria infection following travel in endemic areas. These changes may imply that adaptation of the preventive strategy is needed to reduce the burden of the disease among travelers.

SUBMITTER: Kendjo E

PROVIDER: S-EPMC6523451 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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