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Protocol for Plasmodium falciparum Infections in Mosquitoes and Infection Phenotype Determination
Published on: July 4, 2007
Imported malaria in metropolitan France, from recommendations to clinical practice - proposal for improvement
1Service des maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, groupe hospitalier universitaire AP-HP Nord, AP-HP, Paris, France.
Background:
Approximately 5000 cases of imported malaria are observed each year in metropolitan France. Guidelines for the prevention and management of imported malaria were published by the French infectious disease society (French acronym SPILF) in 2017.
Objective:
Study objective was to describe in a retrospective analysis (2015-2016) imported malaria cases recorded in a Parisian hospital, to analyze the congruence to previous guidelines (2014), deviation in respect to post hoc published guidelines and potential areas for improvement.
Results:
Two hundred and one cases were analyzed using medical charts. There was a majority of men (sex ratio 2/1), with a mean age of 43 years at diagnosis. The main area of infection acquisition was sub-Saharan Africa (97%). The average time since return from the endemic area was 20 days. Patients consulted the emergency department for flu-like syndrome (32%), fever or chills (28%), and gastrointestinal symptoms (22%). Blood smears mainly identified Plasmodium falciparum (n=180, 90%). There were 52 (26%) severe malaria episodes.
Conclusion:
The analysis of national guideline adequacy highlighted difficulties in obtaining a complete biological workup at baseline, managing patients with vomiting, and in the post-treatment follow-up.
Insights
This study reviewed imported malaria cases in Paris, finding challenges in adhering to national guidelines for diagnosis and patient management, particularly concerning initial workups and follow-up care for malaria patients.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Imported malaria is a significant concern in metropolitan France, with approximately 5000 cases annually.
- National guidelines for malaria prevention and management were established by the French infectious disease society (SPILF) in 2017.
Purpose of the Study:
- To retrospectively analyze imported malaria cases from 2015-2016 at a Parisian hospital.
- To assess adherence to 2014 guidelines and identify areas for improvement in malaria case management.
Main Methods:
- Retrospective analysis of 201 medical charts of imported malaria cases.
- Evaluation of diagnostic procedures, clinical presentations, and treatment outcomes.
Main Results:
- The majority of cases (97%) were acquired in sub-Saharan Africa, with Plasmodium falciparum being the predominant species (90%).
- 26% of cases presented as severe malaria, with common symptoms including flu-like illness, fever, chills, and gastrointestinal issues.
- A significant delay of 20 days was observed between return from endemic areas and diagnosis.
Conclusions:
- Challenges were identified in achieving complete baseline biological workups for malaria patients.
- Difficulties were noted in managing malaria patients with vomiting and in ensuring adequate post-treatment follow-up.
- The study highlights the need for improved adherence to national guidelines for imported malaria.
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