title: Severe imported Plasmodium falciparum malaria, France, 1996-2003.
abstract: Little is known about severe imported Plasmodium falciparum malaria in industrialized countries where the disease is not endemic because most studies have been case reports or have included <200 patients. To identify factors independently associated with the severity of P. falciparum, we conducted a retrospective study using surveillance data obtained from 21,888 P. falciparum patients in France during 1996-2003; 832 were classified as having severe malaria. The global case-fatality rate was 0.4% and the rate of severe malaria was ≈3.8%. Factors independently associated with severe imported P. falciparum malaria were older age, European origin, travel to eastern Africa, absence of chemoprophylaxis, initial visit to a general practitioner, time to diagnosis of 4 to 12 days, and diagnosis during the fall-winter season. Pretravel advice should take into account these factors and promote the use of antimalarial chemoprophylaxis for every traveler, with a particular focus on nonimmune travelers and elderly persons.
authors.affiliation: University Pierre et Marie Curie, Paris, France.
authors.forename: Elise
authors.initials: E
authors.lastname: Seringe
authors.forename: Marc
authors.initials: M
authors.lastname: Thellier
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
authors.forename: Fabrice
authors.initials: F
authors.lastname: Legros
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchaud
authors.forename: Thierry
authors.initials: T
authors.lastname: Ancelle
authors.forename: Eric
authors.initials: E
authors.lastname: Kendjo
authors.forename: Sandrine
authors.initials: S
authors.lastname: Houze
authors.forename: Jacques
authors.initials: J
authors.lastname: Le Bras
authors.forename: Martin
authors.initials: M
authors.lastname: Danis
authors.forename: Rémy
authors.initials: R
authors.lastname: Durand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D014195:Travel; D055815:Young Adult