title: Imported malaria is stable from Africa but declining from Asia.
abstract: BACKGROUND
  In this study, we describe patients with imported malaria seen at the Department of Infectious Diseases (DID), Hvidovre Hospital, Denmark. Our aim was to address possible risk factors for contracting malaria and risk factors for developing complicated malaria.
  
  
  METHODS
  We searched patient databases for all cases of malaria seen at the DID from 1994 to 2012. Various parameters were registered.
  
  
  RESULTS
  A total of 320 cases were identified. We found a significant 3.39 % decrease in the incidence of cases per year (p = 0.0008). Plasmodium falciparum infection was predominant (n = 217) followed by P. vivax infection (n = 76). 37% of all cases were Africans visiting relatives and friends (VRF). A total of 12 patients had one or more re-lapses of their P. vivax infection. In all, 53 (17%) cases were defined as severe malaria. 36% (n = 112) reported using some type of chemoprophylaxis. 14% (n = 26) of patients traveling to Africa in 1999-2012 reported taking chemoprophylaxis as recommended in the current guidelines. Complicated malaria was significantly associated with failure to take any chemoprophylaxis (p = 0.0317, χ(2)-test).
  
  
  CONCLUSIONS
  Imported malaria is decreasing at the DID. The patients who carry the highest risk of imported malaria are ethnic Africans who travel as VRF without using chemoprophylaxis. Recrudescence from P. vivax malaria is a substantial risk. Complicated malaria is associated with failure to take any chemoprophylaxis. It is important that travelers receive expedient advice on the use of efficient chemoprophylaxis to bring down the number of imported malaria cases.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Adilsvej 9, 2., 2000 Frederiksberg, Denmark. cholt25@hotmail.com.
authors.forename: Camilla Holten
authors.initials: CH
authors.lastname: Møller
authors.forename: Kim
authors.initials: K
authors.lastname: David
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D001208:Asia; D053626:Atovaquone / Q000627:therapeutic use; D018890:Chemoprevention; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use; D057210:Delayed Diagnosis; D003718:Denmark / Q000453:epidemiology; D004338:Drug Combinations; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy*; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D008875:Middle Aged; D011319:Primaquine / Q000627:therapeutic use; D002727:Proguanil / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D014195:Travel; D055815:Young Adult
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C109496:atovaquone, proguanil drug combination; D002738:Chloroquine; D011319:Primaquine; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone