Journal of Travel Medicine
Volume 17, Issue 4, 2010, Pages 221-227

Imported malaria in children: A comparative study between recent immigrants and immigrant travelers (VFRs) (Article) (Open Access)

Arnáez J.* , Roa M.A. , Albert L. , Cogollos R. , Rubio J.M. , Villares R. , Alarabe A. , Cervera A. , López-Vélez R.
  • a Departments of Pediatrics, Mostoles Hospital, Madrid, Spain
  • b Departments of Pediatrics, Mostoles Hospital, Madrid, Spain
  • c Departments of Pediatrics, Mostoles Hospital, Madrid, Spain
  • d Department of Microbiology and Parasitology, Mostoles Hospital, Madrid, Spain
  • e Department of Parasitology, National Microbiology Centre, Carlos III Health Institute, Madrid, Spain
  • f Departments of Pediatrics, Mostoles Hospital, Madrid, Spain
  • g Departments of Pediatrics, Mostoles Hospital, Madrid, Spain
  • h Departments of Pediatrics, Mostoles Hospital, Madrid, Spain
  • i Tropical Medicine and Clinical Parasitology Unit, Infectious Diseases Department, Ramon y Cajal Hospital, Madrid, Spain

Abstract

Background. In Europe, imported malarial cases occur in returning travelers and immigrants mostly from African countries. There have been an increasing number of cases in the past years in Spain. Methods. An analysis of all cases of malaria who attended at the Hospital of Mostoles in the Southwest of Madrid from 1995 to 2007 was performed. Clinical, epidemiological, laboratory, and parasitological findings were analyzed and compared between immigrants coming from endemic countries (recent immigrants) and children who traveled to endemic areas to visit friends and relatives (VFRs). Results. Sixty cases of imported malaria were detected. Most of the cases (59 of 60) were acquired in sub-Saharan Africa. The most common species was Plasmodium falciparum (43 of 60). Microscopic examination was positive in 95%, and the polymerase chain reaction (PCR) for Plasmodium achieved additional diagnosis in seven cases. Fourteen cases were VFRs; none of them used appropriate malaria chemoprophylaxis. Fever and thrombocytopenia were significantly more common among VFRs. They also had significantly higher parasite density. Twelve cases were asymptomatic at the time of diagnosis; all of them were recent immigrants. Conclusions. VFRs account for a significant number of childhood malarial cases. These patients had not taken malaria chemoprophylaxis and malarial cases were more severe. VFR children are a high-risk group, and pretravel advice should underline the risk for malaria. Recent immigrants can be asymptomatic and parasitemias are lower. Therefore, a high index of suspicion is necessary, and PCR for Plasmodium should be performed in case of negative thick smears. © 2010 International Society of Travel Medicine.

Author Keywords

[No Keywords available]

Index Keywords

pyrimethamine halofantrine sulfadoxine atovaquone plus proguanil immigrant Africa south of the Sahara thrombocytopenia Population Surveillance human travel controlled study Malaria comparative study nonhuman school child Humans anemia Adolescent male Spain preschool child female Infant Child, Preschool newborn Disease Transmission, Infectious Child Welfare prevalence Article Parasitemia major clinical study primaquine fever Plasmodium falciparum Emigration and Immigration smear blood transfusion quinine mefloquine chloroquine Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77954365836&doi=10.1111%2fj.1708-8305.2010.00416.x&partnerID=40&md5=6af7b86fca32053de2184464f5605cbc
DOI: 10.1111/j.1708-8305.2010.00416.x
ISSN: 11951982
Cited by: 28
Original Language: English