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[Malaria surveillance in Germany 2000/2001--results and experience with a new reporting system]
I Schöneberg1, G Krause, A Ammon
1Robert Koch-Institut, Abteilung für Infektionsepidemiologie, Berlin.
Abstract:
In Germany, malaria is one of the most frequently imported infectious diseases. In January 2001, the newly implemented Infektionsschutzgesetz (Law for Protection Against Infectious Diseases) brought some important changes in surveillance case notification procedures. After one year, experience shows that the changes did not affect the continuity and representative nature of malaria reporting in Germany. In the years 2000 and 2001, 836 and 1,040 malaria cases, respectively, were reported. In both years, most of the patients were between 30 and 49 years old. 82 % of the infections had been acquired in Africa, and 11 % in Asia. The predominant parasite species was P. falciparum (70 %), followed by P. vivax (12 % in 2000, and 16 % in 2001, respectively). The majority of infections occurred among tourists, fewer in immigrants or business travellers. About two thirds of all patients had not taken any chemoprophylactics. Compared to previous years a decrease in the number of fatal cases was observed (1998: 21, 1999: 18, 2000: 8, 2001: 8). To ameliorate the situation of imported malaria intensified prevention activities are necessary, including efforts to improve choice and compliance of chemoprophylaxis and to facilitate timely diagnosis and treatment.
Insights
Malaria surveillance in Germany remains robust post-2001 law changes. Imported malaria cases, primarily Plasmodium falciparum from Africa, show a decrease in fatalities, emphasizing prevention needs.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Context:
- Malaria is a significant imported infectious disease in Germany.
- The Infektionsschutzgesetz (Law for Protection Against Infectious Diseases) was implemented in January 2001, altering surveillance and case notification.
- One year of data suggests these changes did not disrupt the continuity or representativeness of malaria reporting.
Purpose:
- To evaluate the impact of the new Infektionsschutzgesetz on malaria surveillance in Germany.
- To analyze trends in imported malaria cases, including demographics, geographical origin, parasite species, and risk factors.
- To assess changes in fatal malaria cases and identify areas for improved prevention.
Summary:
- Malaria reporting in Germany remained consistent after the 2001 law changes, with 836 cases in 2000 and 1,040 in 2001.
- Most infections were acquired in Africa (82%) and Asia (11%), predominantly Plasmodium falciparum (70%), affecting individuals aged 30-49.
- A significant majority (two-thirds) of patients did not use chemoprophylaxis, and a notable decrease in fatal cases was observed compared to previous years.
Impact:
- The study highlights the continued importance of monitoring imported malaria in Germany.
- Findings underscore the need for intensified prevention strategies, focusing on improving chemoprophylaxis adherence and timely diagnosis.
- Reduced fatalities suggest potential effectiveness of current measures but also indicate room for further public health intervention.