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Length of stay in at-risk areas and time to malaria attack on return

Salomé Gallet1, Céline Dard2, Sébastien Bailly3

  • 1Clinical Infectious Disease Unit, Grenoble-Alpes University Hospital, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC 1406 - Inserm - Université Grenoble Alpes, Grenoble, France.

Infectious Diseases Now
|October 27, 2023
PubMed
Abstract

Insights

Malaria attacks after travel are consistently short, typically within two weeks of return, regardless of trip length. This two-week period post-travel is a critical window for malaria symptom onset.

Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Epidemiology

Background:

  • Plasmodium falciparum malaria attacks occur shortly after experimental infection.
  • Observed malaria attacks occur soon after returning from endemic areas, irrespective of travel duration.
  • Investigated the relationship between travel duration and time to malaria attack post-return.

Purpose of the Study:

  • To assess if the time between returning from an endemic area and malaria attack varies with the length of stay.
  • To determine the incubation period and diagnosis timeline for malaria in travelers.
  • To identify a consistent risk period for malaria following international travel.

Main Methods:

  • Analyzed anonymized data from the French National Reference Centre for Malaria (2006-2016).
  • Included 11,823 cases of P. falciparum malaria diagnosed 1 day to 1 year after returning from at-risk areas.
  • Data included travel duration (1 day to 1 year) and time from return to symptom onset/diagnosis.

Main Results:

  • Median trip duration was 31 days.
  • Median time from return to symptom onset was 5 days; to diagnosis was 9 days.
  • Shorter stays (<15 days) had longer times to symptom onset (7 days) and diagnosis (11 days) compared to longer stays (4 and 9 days, respectively).

Conclusions:

  • The time between returning from an endemic area and a malaria attack is short and constant, even after long stays, except for stays under 15 days.
  • The two weeks following return from an at-risk area should be considered a high-risk period for malaria.
  • This finding is crucial for timely diagnosis and management of malaria in travelers.
Keywords:
Emergency Medical ServiceImported malariaNational cohortObservational studyTravel

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