Notifications of imported malaria in Western Australia, 1990-2001: incidence, associated factors and chemoprophylaxis.
OBJECTIVE
To assess changes in and factors associated with recent malaria notifications in Western Australia (WA).


METHODS
Retrospective analysis of the WA Notifiable Infectious Diseases Database and enhanced surveillance questionnaires completed by attending medical practitioners.


METHODS
Cases of malaria notified between January 1990 and December 2001.


METHODS
Annual notifications by demographic variables (including age, sex, occupation and place of residence), region/country of acquisition, chemoprophylaxis used, Plasmodium species and outcome.


RESULTS
482 patients were notified (mean age, 31 years; 80% male); 57% lived in Perth, 31% in country areas and 12% in an immigration detention centre. Comparison between the 6-year periods 1990-1995 and 1996-2001 showed that Plasmodium falciparum cases increased from 29 (14%) to 108 (44%; P < 0.001), while Plasmodium vivax cases decreased from 157 (77%) to 122 (50%; P < 0.001); immigrants in detention, defence force personnel and cases from Africa were increasingly represented (P < 0.05 in each case). Only 31% of patients took regular chemoprophylaxis and, among these, the regimen was appropriate in only a quarter. There was a median period of 3 days between symptom onset and diagnosis. One patient died.


CONCLUSIONS
There has been an increase in P. falciparum cases in WA since 1990. This reflects the influx of immigrants in detention, deployment of military personnel to East Timor and increasing numbers of cases from Africa. A significant number of Australian travellers who developed malaria had not taken chemoprophylaxis either regularly or at all, and, of those who had, the regimen was inadequate in most.
Charles
Donnetta M
DM
School of Medicine and Pharmacology, University of Western Australia, Fremantle, WA.
Hart
Julie
J
Davis
Wendy A
WA
Sullivan
Eleanor
E
Dowse
Gary K
GK
Davis
Timothy M E
TM
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D002648:Child; D018563:Disease Notification / Q000706:statistics & numerical data; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D015994:Incidence; D008288:Malaria / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014195:Travel; D016896:Treatment Outcome; D014904:Western Australia / Q000453:epidemiology
D000962:Antimalarials