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Published on: May 30, 2019
[Imported malaria in children in France]
F Castéla1, F Legros, B Lagardère
1Unité de réanimation médicale, hôpital Saint-Vincent-de-Paul, AP-HP, 82, avenue Denfert-Rochereau, 75014 Paris, France. secretariat.reamed@svp.ap-hop-paris.fr
Unlabelled:
Among the European countries, France is the most affected by imported malaria. The aim of this study was to take stock of the situation of imported malaria in children in France.
Methods:
Attacks of malaria in children less than 15-year-old which have been notified to Centre National de Référence des Maladies d'Importation (CNRMI) were reviewed retrospectively between 1995 and 1997 and 1995 and 1998 for severe malaria.
Results:
Over a period of 3 years, 1256 malaria attacks were notified in children including 90.9% without signs of severity. The mean age was 7 years. Sex ratio was 1.19. About 44.5% were French. Most of the cases were acquired in Africa. Plasmodium falciparum was involved in 79.2% of the cases. About 61.8% of children have been under prophylaxis but only 37.9% admit good compliance. Chemoprophylaxis was frequently inadequate. Halofantrine was prescribed for 76% of these children. Over a 4-year period, 51 children were notified as severe malaria attacks. Among them, 17 had severe malaria as defined by the World Health Organisation criteria. Most of these patients (73%) were treated by quinine by intravenous route. Two children died.
Conclusion:
Paediatric malaria is not rare in France. Only the improvement of prophylaxis could decrease the incidence of malaria in France.
Insights
Imported malaria in children is a significant concern in France, with most cases acquired in Africa. Improving malaria chemoprophylaxis compliance is crucial to reduce incidence.
Area of Science:
- Tropical medicine
- Pediatric infectious diseases
- Epidemiology of imported diseases
Context:
- France experiences a high burden of imported malaria cases.
- Pediatric malaria surveillance is essential for public health.
- Imported diseases pose unique challenges in non-endemic countries.
Purpose:
- To assess the epidemiological characteristics of imported malaria in children in France.
- To evaluate the severity and outcomes of pediatric malaria cases.
- To identify factors contributing to malaria incidence in children.
Summary:
- A retrospective review of 1256 malaria cases in children (under 15) notified to the Centre National de Référence des Maladies d'Importation (CNRMI) between 1995-1997.
- Plasmodium falciparum was the predominant species (79.2%), with most infections acquired in Africa.
- Despite prophylaxis use, compliance was often poor, and chemoprophylaxis frequently inadequate, highlighting a need for improvement.
Impact:
- Findings underscore that pediatric malaria is not uncommon in France.
- The study highlights the critical role of effective malaria chemoprophylaxis in preventing imported cases.
- Recommendations focus on enhancing prophylaxis strategies to reduce the incidence of imported malaria in children.
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