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Imported Malaria in Children: A Study Over an 11-Year Period in Brussels
Valbona Selimaj Kontoni1, Tessa Goetghebuer2, Marc Hainaut2
1From the Department of Pediatrics Clinique Saint-Jean, Brussels, Belgium.
Insights
Imported childhood malaria is rising in non-endemic countries. Most pediatric malaria cases in Brussels were acquired by visiting friends and relatives (VFRs) in endemic areas, with Plasmodium falciparum being most common.
Area of Science:
- Global Health
- Pediatric Infectious Diseases
- Travel Medicine
Background:
- Malaria poses a significant global public health threat, particularly in endemic regions.
- There is a documented increase in imported childhood malaria cases within non-endemic countries.
Purpose of the Study:
- To analyze laboratory-confirmed malaria cases in children aged 0-16 years admitted to two Brussels university hospitals between 2009 and 2019.
- To identify the sources of infection, common malaria species, and outcomes in pediatric malaria patients.
Main Methods:
- A retrospective case review was conducted on all laboratory-confirmed malaria cases in children (0-16 years).
- Data were collected from two large university teaching hospitals in Brussels over a ten-year period (2009-2019).
Main Results:
- 160 pediatric malaria cases were identified, with 68% acquired by children living in Belgium visiting malaria-endemic countries (VFRs).
- Plasmodium falciparum accounted for 89% of cases. 19.3% of cases developed severe malaria, predominantly among VFR travelers.
- Despite 80% seeking travel clinic advice, only one-third adhered to prophylaxis recommendations.
Conclusions:
- Malaria is a notable cause of illness in returning travelers and new immigrants to Belgium.
- While most pediatric cases were uncomplicated, severe malaria occurred, particularly in VFR travelers.
- Enhanced physician education on malaria prevention and prophylaxis for families traveling to endemic areas is crucial.
Background:
Malaria is a major global public health concern in endemic countries and imported childhood malaria is increasing in malaria non-endemic countries.
Methods:
This was a retrospective case review of all laboratory-confirmed malaria cases in children 0-16 years admitted between 2009 and 2019 in 2 large university teaching Hospitals in Brussels.
Results:
A total of 160 children with a median age of 6.8 years (range 5-191 months) were included. We identified 109 (68%) children living in Belgium who had acquired malaria during their visit to malaria-endemic countries to visiting friends and relatives (VFRs), 49 children (31%) visitors or newly installed migrants, and 2 Belgian tourists. Peak seasonal incidence occurred between August and September. Plasmodium falciparum was responsible for 89% of all malaria cases. Almost 80% of children living in Belgium visited a travel clinic for advice, but only one-third reported having taken the prophylaxis schedule according to the recommendations. Based on WHO criteria, 31 children (19.3%) developed severe malaria; most of the patients with severe malaria were VFR travelers and were significantly younger, had higher leukocytosis, had more thrombocytopenia, higher CRP, and lower natremia compared with patients with an uncomplicated course. All children recovered fully.
Conclusions:
Malaria is a significant cause of morbidity among returning travelers and newly arrived immigrants to Belgium. Most of the children had an uncomplicated disease course. Physicians should educate families about traveling to malaria-endemic areas to correct malaria preventive measures and prophylaxis.
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