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Published on: May 30, 2019
[Malaria among immigrants, experience of a Parisian hospital (2006-2010)]
M Develoux1, G Le Loup, S Dautheville
1Hôpital Saint-Antoine, 182, rue du Faubourg-Saint-Antoine, F-75571 Paris Cedex 12, France. michel.develoux@sat.aphp.fr
Abstract:
In recent days immigrants represent the main risk group for imported malaria in northern countries. Most of them are migrants returning to their country of origin to visit friends and relatives (VFR). We retrospectively examined the main clinical, biological, and therapeutic data of all malaria cases in immigrants from 2006 to 2010 in Tenon hospital, Paris. The hospital is situated in a Paris district with an important African community. During the study period 239 imported malaria cases were observed in adults of which 199 were immigrants, 186 VFR, and 13 recently arrived. Most cases were from sub-Saharan Africa and Comoro islands. Chimioprophylaxis was not taken in 81.2% of VFR. It was inadequate in 43.7% and not taken correctly in 84.4%. Plasmodium falciparum was the most frequent species identified: 190/199 (95.5%). Severe P. falciparum malaria was observed in 25 cases (13.2%); two of them were recently arrived. One patient, African VFR, died. In this series two high-risk groups were represented: HIV-infected patients and pregnant women. Six of the HIV patients had severe malaria and all pregnant women had anemia. Our results are similar to those observed recently in other European countries. Mean age of VFR is increasing and the risk for severe P. falciparum malaria became identical to the one observed in non-immune travelers. Protection measures remain still insufficient in this population of travelers.
Insights
Immigrants, especially those visiting friends and relatives (VFR), are a high-risk group for imported malaria. Insufficient chemoprophylaxis use contributes to severe Plasmodium falciparum malaria cases in this population.
Area of Science:
- Tropical medicine
- Infectious diseases
- Public health
Context:
- Immigrants, particularly those undertaking travel to their country of origin (visiting friends and relatives - VFR), represent a significant risk group for imported malaria in non-endemic regions.
- Tenon Hospital in Paris, serving a large African community, observed a high incidence of imported malaria cases among immigrants between 2006 and 2010.
- Sub-Saharan Africa and Comoro Islands were the primary regions of origin for malaria cases in this immigrant population.
Purpose:
- To retrospectively analyze the clinical, biological, and therapeutic data of malaria cases in immigrants treated at Tenon Hospital.
- To identify high-risk subgroups within the immigrant population for severe malaria.
- To evaluate the effectiveness of malaria chemoprophylaxis among VFR travelers.
Summary:
- The study identified 239 imported malaria cases in adults, with 199 being immigrants (186 VFR, 13 recent arrivals).
- Plasmodium falciparum was the predominant species (95.5%), with 13.2% of cases experiencing severe malaria. HIV-infected patients and pregnant women were identified as high-risk groups.
- Chemoprophylaxis uptake was low (81.2% of VFR did not use it), and adherence was poor when used (43.7% inadequate, 84.4% incorrect use).
Impact:
- Findings highlight insufficient malaria prevention measures in VFR travelers, necessitating targeted public health interventions.
- The increasing age of VFR travelers and the comparable risk of severe malaria to non-immune travelers underscore the need for improved awareness and protection.
- This research contributes to understanding imported malaria trends in Europe and informs strategies to mitigate risks in vulnerable migrant populations.
