Imported malaria in France

Data was provided by a surveillance network of laboratories that sent an information form to the CNRMI for each parasite-positive patient; 5,498 cases of malaria were reported from 1995 to 1997 Seventy-nine percent of the cases lived in non-endemic countries. The MIF sex ratio was 1.68. The median age was 29.8 years. Ninety-four percent of the cases were acquired in Africa. The median length of stay was 31 days. The distribution of cases shows a peak in September. Plasmodium falciparum were found in 85% of the reports, P. vivax and P. ovale in 6% each, and P. malariae in 3%. Ninety-three percent of the cases were uncomplicated malaria, and 4% severe malaria. The lethality rate reached 4 parts per thousand. Therapy was given during hospitalization for 78% of the cases and the first-choice drugs were halofantrine (50%) and quinine (27%). Fifty-two point five percent of the patients had followed chemoprophylaxis although with poor compliance: in 65% of the cases medication was neither taken regularly nor for the correct duration, and often did not correspond to the appropriate recommendations for the country concerned. Results from the CNMRI show an increase of imported malaria cases. A large number of travelers are not informed about the risks of malaria in the tropics. Healthcare givers, travel agents, and the media should promote effective prophylaxis in order to reduce the risks of exposure to malaria. (C) 1999 Editions scientifiques et medicales Elsevier SAS.