title: Imported malaria in children in Madrid, Spain, 2007-2013.
abstract: BACKGROUND
  The majority of malaria cases diagnosed in Europe in the last few years have occurred in people living in non-endemic areas travelling back to their home country to visit friends and relatives (VFRs). Children account for 15-20% of imported malaria, with known higher risk of severe disease.
  
  
  METHODS
  A retrospective multicentre study was conducted in 24 hospitals in Madrid (Spain) including patients under 16 years diagnosed with malaria (2007-2013).
  
  
  RESULTS
  A total of 149 episodes in 147 children were reported. Plasmodium falciparum was the species most commonly isolated. Twenty-five patients developed severe malaria and there was one death related to malaria. VFR accounted for 45.8% of our children. Only 17 VFRs had received prophylaxis, and 4 of them taken appropriately. They presented more frequently with fever (98% vs. 69%), a longer time with fever (55 vs. 26%), delay in diagnosis of more than three days (62 vs. 37%), and more thrombocytopenia (65 vs. 33%) than non-VFRs, and with significant differences (p<0.05).
  
  
  CONCLUSIONS
  VFRs represent a large proportion of imported malaria cases in our study. They seldom took adequate prophylaxis, and delayed the visit to the physician, increasing the length of fever and subsequent delaying in diagnosis. Appropriate preventive measures, such as education and pre-travel advices should be taken in this population.
authors.affiliation: Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain. Electronic address: beasoto80@hotmail.com.
authors.forename: Beatriz Soto
authors.initials: BS
authors.lastname: Sánchez
authors.affiliation: Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: L M Prieto
authors.initials: LMP
authors.lastname: Tato
authors.affiliation: Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: S Guillén
authors.initials: SG
authors.lastname: Martín
authors.affiliation: Hospital Principe de Asturias, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Pérez
authors.affiliation: Department of Pediatrics, Hospital Universitario de Fuenlabrada, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Grasa
authors.affiliation: Department of Pediatrics, Hospital Universitario de Móstoles, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Valderrama
authors.affiliation: Department of Pediatrics, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: I de
authors.initials: I
authors.lastname: Augusto
authors.affiliation: Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sierra
authors.affiliation: Department of Pediatrics, Hospital Universitario Doce de Octubre, Madrid, Spain.
authors.forename: M García
authors.initials: MG
authors.lastname: Ros
authors.affiliation: Department of Pediatrics, Hospital Severo Ochoa Leganés, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Aguado
authors.affiliation: Department of Pediatric Infectious Diseases, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: M García López
authors.initials: MGL
authors.lastname: Hortelano
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara / Q000208:ethnology; D000962:Antimalarials / Q000627:therapeutic use; D001208:Asia / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D000076263:Communicable Diseases, Imported / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D057210:Delayed Diagnosis; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D016703:Equatorial Guinea / Q000208:ethnology; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D013030:Spain / Q000453:epidemiology; D000076082:Travel-Related Illness
chemical_list: D000962:Antimalarials
keywords: Children; Imported malaria; Malaria importada; Niños; Visitar a amigos y familiares (VFR); Visiting friends and relatives (VFRs)