Trend analysis of imported malaria in London; observational study 2000 to 2014

Rees, Eleanor M.; Saavedra-Campos, María; Usdin, Martine; Anderson, Charlotte; Freedman, Joanne; Burgh, Jane de; Kirkbride, Hilary; Chiodini, Peter L.; Smith, Valerie; Blaze, Marie; Whitty, Christopher J. M.; Balasegaram, Sooria

doi:10.1016/j.tmaid.2017.04.004

Cited by 20 publications

(17 citation statements)

References 16 publications

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“…Furthermore, the overall share of cases who did take chemoprophylaxis was continuously decreasing over the observation period. A similar trend is observed in other European countries [ 24 ] and the USA [ 23 , 24 ]. The observed decrease was most pronounced among native German cases.…”

Section: Discussionsupporting

confidence: 88%

“…The proportion of cases who took chemoprophylaxis was markedly lower among cases with migration background than among native German cases. This disparity is known [ 22 , 24 – 26 ] and is mostly attributed to a lower risk perception of acquiring malaria and of suffering from severe malaria, and the lower uptake of pre-travel counselling by the population with migration background [ 25 , 26 ]. This is particularly worrying since people whose families originate from malaria-endemic countries tend to use less mosquito protection measures, travel for longer periods and often to more remote areas than tourists and business travellers.…”

Section: Discussionmentioning

confidence: 99%

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Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Vygen-Bonnet

Stark

2018

Malar J

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BackgroundGerman surveillance data showed a sharp rise of malaria cases in 2014 and 2015 due to the increased arrival of refugees from malaria endemic countries. A time series analysis of data from 2001 to 2016 was performed in order to describe the epidemiology of imported malaria in Germany in general and of the recent increase in particular.ResultsIn total, 11,678 malaria cases were notified between 2001 and 2016 (range 526–1063 cases/year). Newly arriving refugees averaged 10 cases/year (1.5%) in 2001–13 and 292.5 cases/year (28.3%) in 2014–15. Plasmodium (P.) falciparum was the most frequently reported species (range 57.2–85.8%), followed by P. vivax (range during 2001–2013: 7.6–18.1%; during 2014–2015, mean 31.3%). In 2014–15, 22.3% of all P. vivax cases were refugees from Eritrea and 3.3% from other countries of the Horn of Africa; in 2015 and 2016, 19.5% were refugees from Afghanistan and Pakistan. Five P. knowlesi malaria infections were reportedly acquired in Thailand between 2012 and 2016. Total numbers of malaria notifications among native Germans and residents with migration background showed an increasing trend since 2007. Chemoprophylaxis use was reported for 24.3% (1695/6984) of cases and showed a declining trend. Native German cases took significantly more frequently chemoprophylaxis than cases with migration background (32.6% vs. 17.9%; p < 0.001).Discussion/conclusionsThe steep rise in vivax malaria notifications in 2014 and 2015 was mainly due to newly arriving refugees from Eritrea but also from other countries of the Horn of Africa and South Asia. Clinicians should include malaria in their differential diagnosis in case of a febrile illness in the respective population and consider vivax malaria even if arrival to Germany dates back several months. Over the past 10 years, malaria notifications among native Germans and residents with migration background showed an increasing trend. Use of chemoprophylaxis was insufficient in both groups and deteriorating. New strategies need to be found to increase compliance to chemoprophylaxis recommendations. The surveillance provides valuable data for epidemiological assessment of imported malaria in Germany.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Vygen-Bonnet

Stark

2018

Malar J

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“…According to the World Health Organisation (WHO), there were 216 million registered malaria cases and 445 thousand deaths in 2016 [34]. In an observational study that analyse the trends in the prevalence of imported malaria in London [35], of a total of 15,473 cases reported between 2000 and 2004, 5.9% were seen in patients older than 60 years; between 2005 and 2009 the prevalence of malaria in this group reached 7.7% and between 2010 and 2014 -8.7%. In the study performed by Allen et al [36], 5.9% of the cases reported between 2002 and 2012 were found in patients aged 65 years or older.…”

Section: Most Common Travel-associated Diseases Arthropod-borne Diseasesmentioning

confidence: 99%

“…Nevertheless, there are many drug-drug interactions between mefloquine and carbamazepine, phenytoin, citalopram, fluoxetine, azithromycin, verapamil, carvedilol or warfarin [10]. Main reasons for declining to take chemoprophylaxis include cost, lack of awareness and scepticism about therapy efficiency, inappropriate assessment of personal risk or failure to access drugs before travel [35]. It is essential to highlight that patients whose main reason to travel is visiting friends and relatives are less likely to take antimalarial prophylaxis [85].…”

Section: Malaria Preventionmentioning

confidence: 99%

The older traveller

Woś

Korzeniewski²

2018

International Maritime Health

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All over the world there has been a sudden increase in the number of international travels, mostly for touristic purposes. According to the World Tourism Organisation, the number of international journeys exceeded 1.323 billion in 2017 and it continues to grow. Of the growing number of travellers more and more are the elderly (> 65 years), this fact can be attributed to longer life expectancy and a better quality of life, especially in the developed countries. The article lists the main destinations chosen by senior tourists and their reasons for travel, it also discusses physiological changes in organs and systems affecting the elderly, which are the result of travelling across time zones and to areas with different environment. The article looks at various groups of patients affected by chronic diseases and examines health-related consequences of travel, including the most common complications. The general health prevention measures, with emphasis on vaccinations and antimalarial chemoprophylaxis, have also been discussed.

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“…The majority of these cases were P.falciparum imported from Western Africa 5 and there were 6 deaths reported in 2017 6 . In addition to the personal impact that malaria can have, there can be a significant financial impact; for example, Rees and colleagues estimated the healthcare costs of malaria hospital admissions in London to be just over one million pounds per year 7 . This is likely to be an underestimation of the true costs as they did not consider other healthcare and non-healthcare community costs or costs to the individual and family.…”

Section: Introductionmentioning

confidence: 99%

Pre-travel malaria enquiries to the United Kingdom national travel advice line 2016: Advice mainly needed on malaria maps and risk groups

Kay

Ive

Petersen

et al. 2019

Travel Medicine and Infectious Disease

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Background: Malaria prevention in travellers can be complex and requires consideration of a number of factors. UK healthcare professionals providing pre-travel malaria advice can access specialist support from the National Travel Health Network and Centre (NaTHNaC) telephone advice line. The aim of this study is to characterise queries to the NaTHNaC telephone advice line regarding pre-travel malaria advice. Method: Telephone calls received to NaTHNaC's advice line are recorded using an online data capture form. All calls relating to malaria advice during 2016 were selected and data extracted. Analysis was undertaken using Microsoft Excel and STATA. Results: During 2016, 1803 malaria-related calls were received; the majority from general practice and calls were from across the UK. The most common type of pre-travel malaria query was country-specific followed by travellers with special health needs. Many queries related to pregnant and breastfeeding travellers, children under 5 years and travellers over 60 years. Conclusions: This review presents a large and exceptional dataset and reflects the ambiguity amongst some healthcare professionals regarding malaria advice. We have identified potential knowledge gaps, and as a result will strengthen future guidance, enhance existing malaria maps, and inform the development of future clinical educational activity.

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Trend analysis of imported malaria in London; observational study 2000 to 2014

Cited by 20 publications

References 16 publications

Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

Changes in malaria epidemiology in Germany, 2001–2016: a time series analysis

The older traveller

Pre-travel malaria enquiries to the United Kingdom national travel advice line 2016: Advice mainly needed on malaria maps and risk groups

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