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Published on: December 28, 2014
Imported malaria in children in Madrid, Spain, 2007-2013
Beatriz Soto Sánchez1, L M Prieto Tato1, S Guillén Martín1
1Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain.
Insights
Imported malaria in children visiting friends and relatives (VFRs) is a significant concern in Europe. VFRs experienced delayed diagnosis and more severe symptoms, highlighting the need for better travel health education.
Area of Science:
- Pediatric Infectious Diseases
- Travel Medicine
- Epidemiology
Background:
- Imported malaria cases in Europe are predominantly diagnosed in individuals visiting friends and relatives (VFRs).
- Children represent 15-20% of imported malaria cases and face a higher risk of severe disease.
Purpose of the Study:
- To analyze imported malaria cases in children under 16 years old in Madrid, Spain.
- To identify risk factors and clinical characteristics associated with malaria in pediatric VFRs.
Main Methods:
- Retrospective multicenter study conducted in 24 hospitals in Madrid.
- Inclusion criteria: patients under 16 years diagnosed with malaria between 2007 and 2013.
Main Results:
- 149 malaria episodes were reported in 147 children, with Plasmodium falciparum being the most common species.
- Twenty-five patients developed severe malaria, and one death occurred.
- VFRs constituted 45.8% of cases, with inadequate prophylaxis uptake (only 17/149 received it, 4 appropriately).
- VFRs presented with more frequent and prolonged fever, delayed diagnosis (>3 days), and higher rates of thrombocytopenia compared to non-VFRs (p<0.05).
Conclusions:
- VFRs are a significant population for imported pediatric malaria.
- Inadequate prophylaxis and delayed medical consultation in VFRs contribute to prolonged illness and diagnostic delays.
- Enhanced pre-travel education and preventive advice are crucial for VFRs to mitigate malaria risks.
Background:
The majority of malaria cases diagnosed in Europe in the last few years have occurred in people living in non-endemic areas travelling back to their home country to visit friends and relatives (VFRs). Children account for 15-20% of imported malaria, with known higher risk of severe disease.
Material And Methods:
A retrospective multicentre study was conducted in 24 hospitals in Madrid (Spain) including patients under 16 years diagnosed with malaria (2007-2013).
Results:
A total of 149 episodes in 147 children were reported. Plasmodium falciparum was the species most commonly isolated. Twenty-five patients developed severe malaria and there was one death related to malaria. VFR accounted for 45.8% of our children. Only 17 VFRs had received prophylaxis, and 4 of them taken appropriately. They presented more frequently with fever (98% vs. 69%), a longer time with fever (55 vs. 26%), delay in diagnosis of more than three days (62 vs. 37%), and more thrombocytopenia (65 vs. 33%) than non-VFRs, and with significant differences (p<0.05).
Conclusions:
VFRs represent a large proportion of imported malaria cases in our study. They seldom took adequate prophylaxis, and delayed the visit to the physician, increasing the length of fever and subsequent delaying in diagnosis. Appropriate preventive measures, such as education and pre-travel advices should be taken in this population.
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