title: Epidemiology of 62 patients admitted to the intensive care unit after returning from Madagascar.
abstract: BACKGROUND
  To our knowledge, there is no data on the epidemiology of patients hospitalized in intensive care unit (ICU) after a stay in Madagascar or other low-income countries. It is possible that such data may improve transfer delays and care quality for these patients.
  
  
  METHODS
  In a retrospective study, we reviewed the charts of all patients admitted to ICU of the Reunion Island Felix Guyon University Hospital from January 2011 through July 2013. We identified all patients who had stayed in Madagascar during the 6 months prior to ICU admission.
  
  
  RESULTS
  Of 1842 ICU patients, 62 (3.4%) had stayed in Madagascar during the 6 months prior to ICU admission. Patients were 76% male and the median age was 60.5 (48.25-64.75) years; patients were more frequently residents of Madagascar than travellers (56.5%). In most cases, patients were not hospitalized or given antibiotics in Madagascar. The most frequent causes of hospitalization were infections including malaria (21%) and lower respiratory infection (11%). Carriage and infection with multidrug resistant (MDR) bacteria on ICU admission were frequent (37% and 9.7%, respectively). The mortality rate in ICU was 21%, and severity acute physiological Score II was 53.5 (37-68).
  
  
  CONCLUSIONS
  Patients admitted to ICU after a stay to Madagascar are mainly elderly patients with chronic illnesses, and often foreign residents. The admission causes are specific of the country like malaria, or specific to the population concerned such as cardiovascular accidents that could be prevented.
authors.affiliation: Intensive Care Unit and allyn.jer@gmail.com.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Allyn
authors.affiliation: Intensive Care Unit and.
authors.forename: Marion
authors.initials: M
authors.lastname: Angue
authors.affiliation: Intensive Care Unit and.
authors.forename: Laure
authors.initials: L
authors.lastname: Corradi
authors.affiliation: Bacteriology laboratory, CHU Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Traversier
authors.affiliation: Bacteriology laboratory, CHU Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Belmonte
authors.affiliation: Intensive Care Unit and.
authors.forename: Myriem
authors.initials: M
authors.lastname: Belghiti
authors.affiliation: Intensive Care Unit and.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Allou
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000401:mortality*; D005260:Female; D005602:France; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008270:Madagascar; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014195:Travel
keywords: Intensive care medicine; Madagascar; infectious disease; travel medicine