Imported malaria in Switzerland, (1990–2019): A retrospective analysis

Giannone, Bodo; Hedrich, Nadja; Schlagenhauf, Patricia

doi:10.1016/j.tmaid.2021.102251

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…Most P. falciparum, P. ovale and P. malariae cases in our study were acquired in Africa, consistent with global species distribution. 63 , 64 However, we found a lower proportion of imported cases acquired in Africa compared with European and North American studies (68–95%), 14 , 15 , 46 , 47 , 56 , 58 reflective of traveller patterns. A study from New Zealand, which has a similar traveller profile to Australia, demonstrated that PNG and the Western Pacific accounted for the majority of imported malaria cases (39%), with Africa accounting for 21%.…”

Section: Discussioncontrasting

confidence: 78%

“…While most reported cases were P. falciparum and acquired in Sub-Saharan Africa, the proportion of cases acquired in Oceania and attributable to P. vivax was notably higher than that reported from most other non-endemic countries (Supplementary material, Table S3 ), where P. vivax only accounts for 4–19% of cases and 5% or fewer of cases are acquired in Oceania. 14 , 46–49 …”

Section: Discussionmentioning

confidence: 99%

“…In Australia, P. vivax accounted for almost one in three imported cases, contrasting with other non-endemic countries, where P. falciparum causes by far the greatest burden of disease, 14 , 46–48 , 56–59 likely reflecting Australia’s geographic location, migration patterns and travellers’ destinations to Asia Pacific where P. vivax is the most common malaria parasite.…”

Section: Discussionmentioning

confidence: 99%

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Imported malaria into Australia: surveillance insights and opportunities

Sohail,

Barry,

Auburn

et al. 2023

Journal of Travel Medicine

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Background Malaria continues to pose a significant burden in endemic countries, many of which lack access to molecular surveillance. Insights from malaria cases in travellers returning to non-endemic areas can provide valuable data to inform endemic country programs. To evaluate the potential for novel global insights into malaria, we examined epidemiological and molecular data from imported malaria cases to Australia. Methods We analysed malaria cases reported in Australia from 2012 to 2022 using National Notifiable Disease Surveillance System (NNDSS) data. Molecular data on imported malaria cases were obtained from literature searches. Results Between 2012 and 2022, 3204 malaria cases were reported in Australia. Most cases (69%) were male and 44% occurred in young adults aged 20–39 years. Incidence rates initially declined between 2012 and 2015, then increased until 2019. During 2012–2019, the incidence in travellers ranged from 1.34 to 7.71 per 100 000 trips. Cases were primarily acquired in Sub-Saharan Africa (n = 1433; 45%), Oceania (n = 569; 18%) and Southern and Central Asia (n = 367; 12%). The most common countries of acquisition were Papua New Guinea (n = 474) and India (n = 277). P. falciparum accounted for 58% (1871/3204) of cases and was predominantly acquired in Sub-Saharan Africa, and P. vivax accounted for 32% (1016/3204), predominantly from Oceania and Asia. Molecular studies of imported malaria cases to Australia identified genetic mutations and deletions associated with drug resistance and false-negative rapid diagnostic test results, and led to the establishment of reference genomes for P. vivax and P. malariae. Conclusions Our analysis highlights the continuing burden of imported malaria into Australia. Molecular studies have offered valuable insights into drug resistance and diagnostic limitations, and established reference genomes. Integrating molecular data into national surveillance systems could provide important infectious disease intelligence to optimise treatment guidelines for returning travellers and support endemic country surveillance programs.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Imported malaria into Australia: surveillance insights and opportunities

Sohail,

Barry,

Auburn

et al. 2023

Journal of Travel Medicine

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“…In the USA approximately 2000 persons were diagnosed with malaria in 2017 of which 14% developed severe disease with a case fatality rate of 0.3% [ 33 ]. In 2021, the UK reported 1,012 cases of imported malaria with 3 deaths (0.3% case fatality, all due to P. falciparum malaria) [ 34 ] and more recently, Giannone et al [ 35 ] reported 8439 imported malaria cases in Switzerland over a thirty year period from 1990 to 2019 with 52 deaths, amounting to a case fatality rate of 0.62% [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

An epidemiological analysis of severe imported malaria infections in Sri Lanka, after malaria elimination

Seneviratne,

Fernando,

Wickremasinghe

et al. 2024

Malar J

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Background Imported malaria continues to be reported in Sri Lanka after it was eliminated in 2012, and a few progress to life-threatening severe malaria. Methods Data on imported malaria cases reported in Sri Lanka from 2013 to 2023 were extracted from the national malaria database maintained by the Anti Malaria Campaign (AMC) of Sri Lanka. Case data of severe malaria as defined by the World Health Organization were analysed with regard to patients’ general characteristics and their health-seeking behaviour, and the latter compared with that of uncomplicated malaria patients. Details of the last three cases of severe malaria in 2023 are presented. Results 532 imported malaria cases were diagnosed over 11 years (2013–2023); 46 (8.6%) were severe malaria, of which 45 were Plasmodium falciparum and one Plasmodium vivax. Most severe malaria infections were acquired in Africa. All but one were males, and a majority (87%) were 26–60 years of age. They were mainly Sri Lankan nationals (82.6%). Just over half (56.5%) were treated at government hospitals. The average time between arrival of the person in Sri Lanka and onset of illness was 4 days. 29 cases of severe malaria were compared with 165 uncomplicated malaria cases reported from 2015 to 2023. On average both severe and uncomplicated malaria patients consulted a physician equally early (mean = 1 day) with 93.3% of severe malaria doing so within 3 days. However, the time from the point of consulting a physician to diagnosis of malaria was significantly longer (median 4 days) in severe malaria patients compared to uncomplicated patients (median 1 day) (p = 0.012) as was the time from onset of illness to diagnosis (p = 0.042). All severe patients recovered without sequelae except for one who died. Conclusions The risk of severe malaria among imported cases increases significantly beyond 5 days from the onset of symptoms. Although patients consult a physician early, malaria diagnosis tends to be delayed by physicians because it is now a rare disease. Good access to expert clinical care has maintained case fatality rates of severe malaria at par with those reported elsewhere.

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“…However, there were frequent reports of non-African travellers diagnosed with P. vivax when they return to their home countries [39]. In recent studies, Sweden and China reported P. vivax among their returnees from these regions (4% and 8% respectively, of total cases originated from these regions) [50]. Nevertheless, there have been rising evidence of P. vivax appears at low prevalence in both Duffy-negative and Duffy-positive populations in West and Central Africa, which suggests the possibility of sustained P. vivax transmission in this region [51].…”

Section: Discussionmentioning

confidence: 99%

Profiling the imported human malaria in Sarawak, Malaysia in 2011–2019

Ooi

Phang

Liew

et al. 2023

Tropical Med Int Health

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Objectives Malaysia has achieved the status of zero indigenous human malaria cases. Nevertheless, imported human malaria has increasingly been reported in Sarawak, Malaysian Borneo. As zoonotic malaria caused by Plasmodium knowlesi remains a major public health problem in Sarawak, the threat of imported malaria must be addressed as it can cause human malaria reintroduction, sustain transmission, and lead to complications. The objectives of this study were to investigate the epidemiological characteristics of imported malaria cases reported in Sarawak and to underline the challenge posed by imported malaria towards malaria elimination efforts. Methods Imported malaria cases reported in Sarawak from 2011 to 2019 were collected from Sarawak State Health Department and analysed in this longitudinal retrospective study. Results A total of 2058 imported malaria cases were registered in all districts in Sarawak. Highest number of cases were reported in Kapit (n = 559; 27.16%), followed by Sibu (n = 424; 20.6%), and Miri (n = 166; 8.07%). Based on the demographic profile, most of the patients constituted of either male sex (98.49%), age group of 40–49 years (39.6%), Iban ethnic (57.92%), worked in logging industry (88.58%), Malaysian nationals (91.84%), contracted malaria in Papua New Guinea (46.11%), uncomplicated disease (77.89%), or hospitalised cases (97.86%). The most prominent Plasmodium species diagnosed were P. vivax (52.67%) and P. falciparum (35.81%). Conclusions Surveillance, disease detection, and medical follow‐up must be carried out thoroughly for individuals who returned from malaria‐endemic countries. It is also necessary to promote pre‐travel preventive education as well as chemoprophylaxis to travellers heading to endemic areas.

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Imported malaria in Switzerland, (1990–2019): A retrospective analysis

Cited by 8 publications

References 19 publications

Imported malaria into Australia: surveillance insights and opportunities

Imported malaria into Australia: surveillance insights and opportunities

An epidemiological analysis of severe imported malaria infections in Sri Lanka, after malaria elimination

Profiling the imported human malaria in Sarawak, Malaysia in 2011–2019

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