[Old age as risk factor for complications of malaria in non-immune travellers]

Malaria plays an important role as a dangerous imported infection in Europe. In addition, the number of elderly travellers is increasing. We examined the hypothesis, whether age can be considered as a risk factor for the development of complications in malaria.

We examined retrospectively 134 case records of patients of all age groups with a plasmodial infection. We analysed personal data, travel details and patient histories, the neurological status, respiratory function, as well as haematological, biochemical and parasitological parameters.

There is significant evidence for a correlation between age and the frequency of complications in malaria like cerebral involvement, respiratory failure, renal failure, anaemia, and hyperparasitaemia. Out of 132 patients over 15 years of age, 49 (37.1 %) developed a severe course of malaria. In the age group of 60 years and above this percentage increased to 61.5 %. The age distribution in the group with severe malaria was significantly shifted towards the elderly (p = 0.016 in Mann-Whitney test). The duration of hospitalisation also increased with age from an average of five days for the group below 45 years to 21 days for the elderly of 60 years and above.

Our findings suggest a higher risk for a severe course of malaria in the elderly. For this reason, extensive advice on the correct use of exposure- and chemoprophylaxis of malaria is especially important for travellers above the age of 60.