Abstract
Abstract Plasmodium falciparum malaria is a serious health hazard for travelers to malaria-endemic areas and is often diagnosed on return to the country of residence. We conducted a retrospective study of imported falciparum malaria among travelers returning to France from malaria-endemic areas from 1996 through 2003. Epidemiologic, clinical, and parasitologic data were collected by a network of 120 laboratories. Factors associated with fatal malaria were identified by logistic regression analysis. During the study period, 21,888 falciparum malaria cases were reported. There were 96 deaths, for a case-fatality rate of 4.4 per 1,000 cases of falciparum malaria. In multivariate analysis, risk factors independently associated with death from imported malaria were older age, European origin, travel to East Africa, and absence of chemoprophylaxis. Fatal imported malaria remains rare and preventable. Pretravel advice and malaria management should take into account these risk factors, particularly for senior travelers.
Highlights
Dengue and malaria are two major arthropod-borne infections in tropical areas, but dual infections were only described for the first time in 2005
The influence of co-infections on severity is not straightforward, the aim of this study was to differentiate clinical and biological picture of co-infections from infections alone and determine whether patients infected by both malaria and dengue (MD) were more severe than either infection alone
Since the first cases of dengue fever (DF) were reported in French Guiana in 1943, an increase in the number of DF cases and DF outbreaks and the emergence of dengue hemorrhagic fever (DHF) have been observed [15]
Summary
Dengue and malaria are two major arthropod-borne infections in tropical areas, but dual infections were only described for the first time in 2005. Reports of these concomitant infections are scarce and there is no evidence of more severe clinical and biological pictures than single infections. Plasmodium falciparum and/or Plasmodium vivax in India and Pakistan [2,3,4,5], Southeast Asia [6,7], French Guiana [8] and Brazil [9]. The influence of co-infections on severity is not straightforward, the aim of this study was to differentiate clinical and biological picture of co-infections from infections alone and determine whether patients infected by both malaria and dengue (MD) were more severe than either infection alone (respectively M and D)
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