Impact of imported malaria on the burden of disease in northeastern Venezuela.
BACKGROUND
Many countries throughout the world are reporting an increasing number of imported malaria cases. It is now well documented that population movements play an important role in the spread and introduction of malaria infection in nonendemic areas.


METHODS
We evaluated the contribution of imported malaria to the overall malaria burden of disease in an already endemic malaria region in Venezuela, where malaria is exclusively caused by Plasmodium vivax. To estimate the magnitude of this contribution, we retrospectively analyzed cases of imported malaria in Sucre, Venezuela, during a 10-year period (1987-1998).


RESULTS
During this period, 1,755 (3.8% of the total) cases of imported malaria were identified. Most of these cases were imported from the Meridian states into Sucre. In Latin America, a major factor in the reemergence and spread of malaria is human migration. Surveillance of imported cases of malaria in Venezuela would allow us to continue evaluating population migration dynamics and its epidemiologic impact on malaria transmission.


CONCLUSIONS
Enhanced surveillance, such as the one shown in this study, would help the early identification of nonindigenous Plasmodium species and also of resistant Plasmodium strains with a potential to spread locally. Population mobility and imported malaria cases may add to the magnitude of malaria burden in some regions of Latin America. Furthermore, malaria treatment guidelines at local and national levels need to incorporate imported malaria cases in their treatment algorithms and into chemoprophylactic recommendations for travelers.
Rodríguez-Morales
Alfonso J
AJ
Centro Trujillano de Investigaciones Parasitológicas José Witremundo Torrealba, Núcleo Universitario Rafael Rangel, Universidad de Los Andes, Trujillo, Venezuela.
Delgado
Laura
L
Martínez
Nestor
N
Franco-Paredes
Carlos
C
D017281:Cost of Illness; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology*; D016778:Malaria, Falciparum / Q000453:epidemiology; D016780:Malaria, Vivax / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D011322:Primary Prevention / Q000458:organization & administration; D012189:Retrospective Studies; D014195:Travel / Q000706:statistics & numerical data*; D014687:Venezuela / Q000453:epidemiology