Malaria in travelers: a review of the GeoSentinel surveillance network.
BACKGROUND
Malaria is a common and important infection in travelers.


METHODS
We have examined data reported to the GeoSentinel surveillance network to highlight characteristics of malaria in travelers.


RESULTS
A total of 1140 malaria cases were reported (60% of cases were due to Plasmodium falciparum, 24% were due to Plasmodium vivax). Male subjects constituted 69% of the study population. The median duration of travel was 34 days; however, 37% of subjects had a travel duration of < or =4 weeks. The majority of travellers did not have a pretravel encounter with a health care provider. Most cases occurred in travelers (39%) or immigrants/refugees (38%). The most common reasons for travel were to visit friends/relatives (35%) or for tourism (26%). Three-quarters of infections were acquired in sub-Saharan Africa. Severe and/or complicated malaria occurred in 33 cases, with 3 deaths. Compared with others in the GeoSentinel database, patients with malaria had traveled to sub-Saharan Africa more often, were more commonly visiting friends/relatives, had traveled for longer periods, presented sooner after return, were more likely to have a fever at presentation, and were less likely to have had a pretravel encounter. In contrast to immigrants and visitors of friends or relatives, a higher proportion (73%) of the missionary/volunteer group who developed malaria had a pretravel encounter with a health care provider. Travel to sub-Saharan Africa and Oceania was associated with the greatest relative risk of acquiring malaria.


CONCLUSIONS
We have used a global database to identify patient and travel characteristics associated with malaria acquisition and characterized differences in patient type, destinations visited, travel duration, and malaria species acquired.
Leder
Karin
K
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia. karin.leder@med.monash.edu.au
Black
Jim
J
O'Brien
Dan
D
Greenwood
Zoe
Z
Kain
Kevin C
KC
Schwartz
Eli
E
Brown
Graham
G
Torresi
Joseph
J
D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D017691:Caribbean Region / Q000453:epidemiology; D002489:Central America / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D044349:Oceania; D011159:Population Surveillance; D012306:Risk; D013020:South America / Q000453:epidemiology; D014195:Travel