Imported malaria in children in Madrid, Spain, 2007–2013

Sánchez, Beatriz Soto; Tato, Luis Manuel Prieto; Martín, Sara Guillén; Pérez, E.; Grasa, Carlos; Valderrama, Sandra; Augusto, I. de; Sierra, M.; Ros, Miriam; Aguado, Isabel; Hortelano, M. García López

doi:10.1016/j.eimc.2016.11.014

Cited by 9 publications

(11 citation statements)

References 15 publications

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“…The proportion of cases who took chemoprophylaxis was markedly lower among cases with migration background than among native German cases. This disparity is known [ 22 , 24 – 26 ] and is mostly attributed to a lower risk perception of acquiring malaria and of suffering from severe malaria, and the lower uptake of pre-travel counselling by the population with migration background [ 25 , 26 ]. This is particularly worrying since people whose families originate from malaria-endemic countries tend to use less mosquito protection measures, travel for longer periods and often to more remote areas than tourists and business travellers.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly worrying since people whose families originate from malaria-endemic countries tend to use less mosquito protection measures, travel for longer periods and often to more remote areas than tourists and business travellers. In addition, this group of people is reported to seek medical attention in case of a febrile illness later upon return to Europe [ 25 , 26 ]. Interestingly, despite residents with migration background taking less chemoprophylaxis, there were fewer fatal cases among them than among native German cases.…”

Section: Discussionmentioning

confidence: 99%

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Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Vygen-Bonnet

Stark

2018

Malar J

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BackgroundGerman surveillance data showed a sharp rise of malaria cases in 2014 and 2015 due to the increased arrival of refugees from malaria endemic countries. A time series analysis of data from 2001 to 2016 was performed in order to describe the epidemiology of imported malaria in Germany in general and of the recent increase in particular.ResultsIn total, 11,678 malaria cases were notified between 2001 and 2016 (range 526–1063 cases/year). Newly arriving refugees averaged 10 cases/year (1.5%) in 2001–13 and 292.5 cases/year (28.3%) in 2014–15. Plasmodium (P.) falciparum was the most frequently reported species (range 57.2–85.8%), followed by P. vivax (range during 2001–2013: 7.6–18.1%; during 2014–2015, mean 31.3%). In 2014–15, 22.3% of all P. vivax cases were refugees from Eritrea and 3.3% from other countries of the Horn of Africa; in 2015 and 2016, 19.5% were refugees from Afghanistan and Pakistan. Five P. knowlesi malaria infections were reportedly acquired in Thailand between 2012 and 2016. Total numbers of malaria notifications among native Germans and residents with migration background showed an increasing trend since 2007. Chemoprophylaxis use was reported for 24.3% (1695/6984) of cases and showed a declining trend. Native German cases took significantly more frequently chemoprophylaxis than cases with migration background (32.6% vs. 17.9%; p < 0.001).Discussion/conclusionsThe steep rise in vivax malaria notifications in 2014 and 2015 was mainly due to newly arriving refugees from Eritrea but also from other countries of the Horn of Africa and South Asia. Clinicians should include malaria in their differential diagnosis in case of a febrile illness in the respective population and consider vivax malaria even if arrival to Germany dates back several months. Over the past 10 years, malaria notifications among native Germans and residents with migration background showed an increasing trend. Use of chemoprophylaxis was insufficient in both groups and deteriorating. New strategies need to be found to increase compliance to chemoprophylaxis recommendations. The surveillance provides valuable data for epidemiological assessment of imported malaria in Germany.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Vygen-Bonnet

Stark

2018

Malar J

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“…This outbreak was arguably expected given that key ingredients for transmission were present. First, pathogens such as DENV, Zika virus (ZIKV) and CHIKV are frequently imported by travelers [19–21]. Second, arboviruses such as DENV, ZIKV, CHIKV and Yellow Fever virus (YFV) can be transmitted by Ae .…”

Section: Introductionmentioning

confidence: 99%

Phenotypic insecticide resistance in arbovirus mosquito vectors in Catalonia and its capital Barcelona (Spain)

et al. 2019

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A range of mosquito species that belong to the Culicidae family are responsible for the worldwide transmission of infectious arboviral diseases such as dengue fever, Zika, West Nile fever and Chikungunya fever. Spain is at risk of arbovirus outbreaks, as various arboviral diseases are frequently introduced and it has established competent vector populations. Autochthonous human cases of West Nile virus have been reported infrequently since 2004, and since October 2018 three autochthonous human case of dengue fever have been confirmed. In response to an outbreak of any arboviral disease, space spraying or fogging will be implemented to control adult mosquito populations. To ensure adulticiding is cost-effective, the insecticide susceptibility status of vectors throughout Catalonia, an autonomous region in north-eastern Spain, was assessed through standardized WHO tube and CDC bottle bioassays. All Culex pipiens populations tested were resistant to at least one of the pyrethroids tested, whereas Aedes albopictus populations were susceptible to all pyrethroids tested. More detailed studies on the Cx . pipiens populations from the Barcelona area (the capital and largest city of Catalonia) revealed resistance to all four classes of public health insecticides available (pyrethroids, carbamates, organophosphates and organochlorides). All Ae . albopictus populations were susceptible to those classes, except for one of the tests performed with pirimiphos-methyl (an organophosphate). Pyrethroids are currently the first line chemical class to be used in space spray operations in response to an outbreak of an arboviral disease. While pyrethroids can be effective in reducing Ae . albopictus populations, this class may not be effective to control Cx . pipiens populations.

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“…Sin embargo, en nuestro estudio, de los 3 niños que no presentaron fiebre, lo era dos habían viajado a su lugar de origen y otro no había viajado. La frecuencia de síntomas gastrointestinales en los niños coincidió con lo reflejado en otros estudios 9 , 10 . Otras manifestaciones clínicas también descritas en la literatura especializada son losescalofríos, la tos, la cefalea, la odinofagia y laastenia.…”

Section: Resultsunclassified

“…Según los datos de la OMS, los niños menores de 5 años son los más vulnerables. En la presente serie, este grupo representó casi el 42 % (10 niños), resultados similares a los de otras publicaciones españolas 9 , 10 . En nuestro este estudio no se encontraron diferencias estadísticamente significativas en la forma de presentación clínica ni en los análisis, tampoco en la necesidad de ingreso en la unidad pediátrica de cudado intensivo, probablemente por el bajo número de casos, pero sí en cuanto a los menores de 5 años que requirieron hospitalizaciones más prolongadas que los mayores de 5 años.…”

Section: Resultsunclassified

Malaria importada en población pediátrica de Alicante, España (1994-2019)

et al. 2022

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Introducción. En los últimos años ha aumentado la malaria importada en niños, en quienes la enfermedad es potencialmente grave y mortal.Objetivo. Describir la incidencia y características clínico-epidemiológicas de niños con diagnóstico de conmalaria en Alicante, España, en los últimos años.Materiales y métodos. Se hizo un estudio observacional y retrospectivo de los casos de malaria en menores de 15 años, diagnosticados en el Hospital General Universitario de Alicante desde 1994 hasta 2019.Resultados. Se registraron 24 casos. El número de casos pasó de dos en el primer quinquenio a 11 en el último. La mediana de edad fue de 6 años (rango intercuartílico: 3 a 8). El 91,6 % procedía de África subsahariana. Los niños nacidos en España de padres inmigrantes que viajan a una zona endémica para visitar a familiares y amigos (Visiting Friends and Relatives) representaron el 62,5 % (n=15) y solo consta que recibiera quimioprofilaxis antipalúdica un paciente (6,7 %). Los signos clínicos más frecuentes fueron fiebre (86,9 %), hepatoesplenomegalia (70,8 %) y anemia (70,8 %). Plasmodium falciparum fue la especie más frecuentemente identificada (83,3 %; n=20). El tratamiento más empleado fue la combinación de dihidroartemisina y piperaquina por vía oral (41,6 %, n=10), con evolución favorable en todos los casos.Conclusiones. Los casos de paludismo infantil importado están aumentando en los últimos años. Las manifestaciones clínicas son inespecíficas en estos niños, por lo que es importante que los profesionales conozcan la enfermedad y tengan un alto índice de sospecha para iniciar el tratamiento precoz. Además, deben tomarse las medidas preventivas adecuadas antes de un viaje.

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Imported malaria in children in Madrid, Spain, 2007–2013

Cited by 9 publications

References 15 publications

Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Phenotypic insecticide resistance in arbovirus mosquito vectors in Catalonia and its capital Barcelona (Spain)

Malaria importada en población pediátrica de Alicante, España (1994-2019)

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