Despite sophisticated intensive medicine, between one and three malaria-associated deaths occur annually in Switzerland. In this retrospective study, 33 deaths (25 men and 8 women) caused by falciparum malaria reported in Switzerland from 1988 to 2002 were analyzed. The case fatality ratio (CFR) for the falciparum infections for the 15-year period was 1.2%, with a peak of 2.2% in 1991. Sub-Saharan Africa was the source of all the imported fatal infections. Non-immune Europeans had a significantly higher case fatality ratio than the non-Europeans (1.7% versus 0.2%; P < 0.001). Careless use or non-use of prophylaxis, sometimes because of physicians giving unsatisfactory pre-travel advice, and initially missed diagnosis post-travel were factors that contributed to the development of severe infections leading to death. Travelers should be sensitized to the risk of malaria by well-informed general practitioners. Updated information is readily available (www.safetravel.ch). Regarding diagnosis and treatment, greater physician awareness of the disease is needed, and expert advice should be sought without hesitation. Rapid malaria tests may be a useful diagnostic adjunct in centers where microscopic expertise is lacking. Falciparum malaria in a non-immune patient is an emergency requiring immediate treatment.

Background In the 11th revision of the International Classification of Diseases (ICD-11) posttraumatic stress disorder (PTSD) and the complex variant (CPTSD) were newly conceptualised. The International Trauma Questionnaire (ITQ) was developed as a brief self-report measure to screen for both disorders. The English original version has been rigorously tested and presents convincing psychometric properties. The aim of the current study was to validate the German version by means of item response theory (IRT). Method This is a secondary analysis of a representative, trauma-exposed adult sample from the German general population (N = 500). 1- and 2-parameter logistic IRT models (i.e. examination on an item level), diagnostic rates and confirmatory factor analyses were calculated. Results All items showed good model fit and acceptable to good performance aligning with the items of the English original except for item C1 (Long time to calm down) which had a high endorsement rate and a low discriminatory power yielding low information gain. CPTSD diagnostic rate of 3.2% was lower than in comparable literature. Confirmatory factor analysis deemed the six first-order, two second-order factors model superior. Conclusion Measurement and factorial validity of the German version of the ITQ was confirmed. The German translation matches the English original in most psychometric properties and can thus be used for research and clinical practice.

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