The low and declining risk of malaria in travellers to Latin America: is there still an indication for chemoprophylaxis?

• Published in: Malaria Journal
• Main Authors: Mühlberger Nikolai, Legros Fabrice, Jelinek Tomas, Hatz Christoph, Hellgren Urban, Bouchaud Olivier, Beran Jiri, Carroll Bernadette, Behrens Ron H, Myrvang Bjørn, Siikamäki Heli, Visser Leo
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2007
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/1475-2875-6-114; https://doaj.org/article/b5e692975fd34638b35037bc3a9b1f4f

Abstract A comparison was made between local malaria transmission and malaria imported by travellers to identify the utility of national and regional annual parasite index (API) in predicting malaria risk and its value in generating recommendations on malaria prophylaxis for travellers. Regional malaria transmission data was correlated with malaria acquired in Latin America and imported into the USA and nine European countries. Between 2000 and 2004, most countries reported declining malaria transmission. Highest API's in 2003/4 were in Surinam (287.4) Guyana (209.2) and French Guiana (147.4). The major source of travel associated malaria was Honduras, French Guiana, Guatemala, Mexico and Ecuador. During 2004 there were 6.3 million visits from the ten study countries and in 2005, 209 cases of malaria of which 22 (11%) were Plasmodium falciparum . The risk of adverse events are high and the benefit of avoided benign vivax malaria is very low under current policy, which may be causing more harm than benefit.