Clinical, geographical, and temporal risk factors associated with presentation and outcome of vivax malaria imported into the United Kingdom over 27 years: observational study

Broderick, Claire; Nadjm, Behzad; Smith, Valerie; Blaze, Marie; Chiodini, Peter L.; Whitty, Christopher J M

doi:10.1136/bmj.h1703

Cited by 41 publications

(32 citation statements)

References 34 publications

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“…It has been argued before that the malaria risk for travellers is not correlated with infection rates in the local population and attack rates in visitors may likely be higher because of the absence of partial immunity in contrast to the local populations [33]. Recent studies confirmed the trend of decreasing cases of imported malaria cases from SEA [9, 34]. According to data from malaria surveillance reports from the USA and 12 European countries, malaria cases imported from countries of SEA declined by 47% between 2003 and 2008 [8].…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, numbers of travellers to those regions have increased substantially due to a major surge in the availability of flight connections as well as a dramatic decrease in airline fares [7]. Concurrently to increased travel, malaria transmission in most parts of SEA has decreased, resulting in smaller numbers of imported malaria from the region [8, 9]. India also recorded a decline in malaria cases, but predominantly through control of falciparum malaria.…”

Section: Introductionmentioning

confidence: 99%

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Response to fever and utilization of standby emergency treatment (SBET) for malaria in travellers to Southeast Asia: a questionnaire-based cohort study

Vinnemeier

Rothe

Kreuels

et al. 2017

Malar J

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BackgroundGuidelines in several European countries recommend standby emergency treatment (SBET) for travellers to regions with low or medium malaria transmission instead of continuous chemoprophylaxis: travellers are advised to seek medical assistance within 24 h in case of fever and to self-administer SBET only if they are not able to consult a doctor within the time period specified. Data on healthcare-seeking behaviour of febrile travellers and utilization of SBET is however scarce as only two studies were performed in the mid-1990s. Since tourism is constantly increasing and malaria epidemiology has dramatically changed in the meantime more knowledge is urgently needed.MethodsSome 876 travellers to destinations in South and Southeast Asia with low or medium malaria transmission were recruited in the travel clinic of the University Medical Center Hamburg-Eppendorf. Demographic and travel-related data were collected by using questionnaires. Pre-travel advice was carried out and SBET was prescribed in accordance to national guidelines. Post-travel phone interviews were performed to assess health incidents during travel and individual responses of travellers to febrile illness.ResultsOut of 714 patients who were monitored, 130 (18%) reported onset of fever during travel or 14 days after return. Of those travellers who reported fever, 100 (80%) carried SBET during travel. The vast majority of 79 (79%) febrile travellers who carried SBET did not seek medical assistance. Overall, 14 (14%) febrile patients who carried SBET and six (20%) patients who did not carry SBET took the correct measure (doctor visit or timely SBET administration) as a response to febrile illness, respectively. Only two travellers self-administered SBET, but both of them applied the wrong regimen.ConclusionsIn view of declining malaria transmission and improving medical infrastructure in most countries of Southeast Asia and obvious obstacles concerning SBET as shown in this study the current strategy should be re-evaluated. Pre-travel advice concerning malaria in SEA should focus on appropriate mosquito bite protection and clearly emphasize the need to see a doctor within 24 h after onset of fever.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Response to fever and utilization of standby emergency treatment (SBET) for malaria in travellers to Southeast Asia: a questionnaire-based cohort study

Vinnemeier

Rothe

Kreuels

et al. 2017

Malar J

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“…Since wild chimpanzees in West and Central Africa were confirmed hosts of P. vivax-like strains, it was hypothesised that wild apes could act as a natural reservoir (Rayner et al, 2011), thereby explaining the occasional infection of travellers despite the low prevalence of P. vivax in the human populations of these regions (Broderick et al, 2015;Culleton et al, 2008;Gautret et al, 2001;Mühlberger et al, 2004;Skarbinski et al, 2006). Moreover, a P. vivax-like parasite isolated from a traveller coming back from a Central African forest was recently shown to cluster with the AGA isolates outside of the human lineage, confirming the occurrence of cross-species transmissions (Liu et al, 2014;Prugnolle et al, 2013).…”

Section: Interspecies Transmissionmentioning

confidence: 99%

Wild African great apes as natural hosts of malaria parasites: current knowledge and research perspectives

Nys

Löhrich

et al. 2017

Primate Biol.

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Abstract. Humans and African great apes (AGAs) are naturally infected with several species of closely related malaria parasites. The need to understand the origins of human malaria as well as the risk of zoonotic transmissions and emergence of new malaria strains in human populations has markedly encouraged research on great ape Plasmodium parasites. Progress in the use of non-invasive methods has rendered investigations into wild ape populations possible. Present knowledge is mainly focused on parasite diversity and phylogeny, with still large gaps to fill on malaria parasite ecology. Understanding what malaria infection means in terms of great ape health is also an important, but challenging avenue of research and has been subject to relatively few research efforts so far. This paper reviews current knowledge on African great ape malaria and identifies gaps and future research perspectives.

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“…However, P. falciparum malaria importation from endemic regions and the threat of spreading drug resistance remains a problem for many eliminating or malaria-free countries due to the difficulty of diagnosis, substantial burden of treatment, relatively high mortality rates, and potential secondary local transmission67. The importation of malaria from Africa has been common over the past decades in non-endemic countries such as the UK and France, that have historical, language and cultural ties89, and certain demographic groups exhibit substantially higher infection rates, such travellers visiting friends and relatives in endemic countries71011.…”

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confidence: 99%

Plasmodium falciparum malaria importation from Africa to China and its mortality: an analysis of driving factors

Lai

Wardrop

Huang

et al. 2016

Sci Rep

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Plasmodium falciparum malaria importation from Africa to China is rising with increasing Chinese overseas investment and international travel. Identifying networks and drivers of this phenomenon as well as the contributors to high case-fatality rate is a growing public health concern to enable efficient response. From 2011–2015, 8653 P. falciparum cases leading to 98 deaths (11.3 per 1000 cases) were imported from 41 sub-Saharan countries into China, with most cases (91.3%) occurring in labour-related Chinese travellers. Four strongly connected groupings of origin African countries with destination Chinese provinces were identified, and the number of imported cases was significantly associated with the volume of air passengers to China (P = 0.006), parasite prevalence in Africa (P < 0.001), and the amount of official development assistance from China (P < 0.001) with investment in resource extraction having the strongest relationship with parasite importation. Risk factors for deaths from imported cases were related to the capacity of malaria diagnosis and diverse socioeconomic factors. The spatial heterogeneity uncovered, principal drivers explored, and risk factors for mortality found in the rising rates of P. falciparum malaria importation to China can serve to refine malaria elimination strategies and the management of cases, and high risk groups and regions should be targeted.

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Clinical, geographical, and temporal risk factors associated with presentation and outcome of vivax malaria imported into the United Kingdom over 27 years: observational study

Abstract: ObjeCtiveTo examine temporal and geographical trends, risk factors, and seasonality of imported vivax malaria in the United Kingdom to inform clinical advice and policy. DesignObservational study.

Cited by 41 publications

References 34 publications

Response to fever and utilization of standby emergency treatment (SBET) for malaria in travellers to Southeast Asia: a questionnaire-based cohort study

Response to fever and utilization of standby emergency treatment (SBET) for malaria in travellers to Southeast Asia: a questionnaire-based cohort study

Wild African great apes as natural hosts of malaria parasites: current knowledge and research perspectives

Plasmodium falciparum malaria importation from Africa to China and its mortality: an analysis of driving factors

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