Antimosquito precautions and medical chemoprophylaxis in French children with malaria.
BACKGROUND
France is the European country with the highest number of imported malaria cases (7,500 in 2000). The aim of this prospective study was to evaluate the nature and efficacy of prophylactic measures in children under 15 years of age referred for malaria.


METHODS
Post travel questionnaires were given to the parents of malarial children in the emergency room. The study took place in two university hospitals in Marseilles, southern France, from August to October 2001.


RESULTS
Eighty-eight children under 15 years of age were included in this 3-month period. Most of them had been infected in Comoro archipelago. Almost two-thirds used bed nets, but only 47% did so every night. Sprayed bed nets were used by 23%. Average compliances with cutaneous repellents, bedroom repellents and long-sleeved clothing were 32%, 24% and 26%, respectively. Air conditioners were uncommon. Only 22% of the children used chemoprophylaxis correctly, according to French recommendations. Five percent did not use any chemoprophylaxis, and 61% reported non recommended drug use. Although all the children traveled to chloroquine-resistant areas, chemoprophylaxis with mefloquine was less common than that with chloroquine + proguanil. No child fully complied with French recommendations concerning both anti mosquito measures and chemoprophylaxis.


CONCLUSIONS
Insufficient use of antimalaria precautions by traveling families is associated with the high incidence of pediatric imported malaria in southern France. Travelers' education should be increased to allow the optimization of malaria prophylaxis.
Minodier
Philippe
P
Pediatric Emergency Unit, CHU Nord, Marseille, France.
Kone-Paut
Isabelle
I
Nassur
Assimouna
A
Launay
Frank
F
Jouve
Jean-Luc
JL
Hassid
Sophie
S
Retornaz
Karine
K
Garnier
Jean-Marc
JM
D000293:Adolescent; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D001512:Bedding and Linens / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use; D003020:Clothing / Q000706:statistics & numerical data; D009033:Culicidae; D004636:Emergency Service, Hospital; D005260:Female; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007299:Insect Bites and Stings / Q000517:prevention & control*; D007302:Insect Repellents / Q000627:therapeutic use; D008288:Malaria / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D010349:Patient Compliance / Q000706:statistics & numerical data; D010961:Plasmodium / Q000302:isolation & purification; D002727:Proguanil / Q000627:therapeutic use; D011446:Prospective Studies; D014195:Travel / Q000706:statistics & numerical data
D000962:Antimalarials; D007302:Insect Repellents; D002738:Chloroquine; D002727:Proguanil; D015767:Mefloquine