title: Imported malaria in a tertiary hospital in Belgium: epidemiological and clinical analysis.
abstract: OBJECTIVE
  There has been a marked increase in tourism, immigration, and business travel to malaria-endemic areas. Non-immune individuals (western travellers) or immigrants living for more than one year in non-endemic areas who visit friends and relatives (VFR) are particularly susceptible to developing severe malaria when travelling to areas with high levels of transmission. In this study, epidemiological, clinical and biological features of malaria in travellers returning from endemic areas were analysed. This may help clinicians unfamiliar with malaria not to overlook this disease in its early stage, and to initiate prompt treatment.
  
  
  METHODS
  We retrospectively analysed all cases of patients who presented with malaria in our institution between 2003 and 2008.
  
  
  RESULTS
  Eighty patients were included. Most patients visited Africa (93.6%). Accordingly, P. falciparum was the main species identified (67/77 patients i.e. 87%). Sixty-five patients (65/78 i.e. 83.3%) had not taken any prophylaxis and 13 (16.7%) had taken it inadequately. Common clinical features were fever (80/80, 100%), influenza-like symptoms (16/80, 20.1%), respiratory symptoms (5/80, 6.3%), neurological symptoms (2/80, 2.5%) or digestive symptoms (15/80, 18.8%). Digestive symptoms were predominant in children < 16 y.o. (60% of these patients).
  
  
  CONCLUSIONS
  Imported malaria cases are mostly related to the lack of adequate use of chemoprophylaxis. Plasmodium falciparum is the main species responsible for imported cases of malaria in our institution. Clinical features vary, but fever is universally present at presentation. As such, all cases of fever upon return from a malaria-endemic area must be considered as malaria until proven otherwise, at least during the first three months after the return.
authors: 'Department of Internal Medicine, Infectious Diseases and Tropical Medicine Unit, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium. jean.yombi@uclouvain.be
authors: J C
authors: JC
authors: Yombi
authors: S
authors: S
authors: Jonckheere
authors: G
authors: G
authors: Colin
authors: F
authors: F
authors: Van Gompel
authors: E
authors: E
authors: Bigare
authors: L
authors: L
authors: Belkhir
authors: B
authors: B
authors: Vandercam
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use; D001530:Belgium / Q000453:epidemiology; D018890:Chemoprevention; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D062606:Tertiary Care Centers; D014195:Travel
chemical_list: D000962:Antimalarials