Epidemiology and clinical features of vivax malaria imported to Europe: Sentinel surveillance data from TropNetEurop

• Published in: Malaria Journal
• Main Authors: Malvy DJM, Kotlowski A, Iversen J, Knobloch J, Kapaun A, Kollaritsch H, Hatz C, Holthoff-Stich ML, Laferl H, Myrvang B, Schmid ML, Puente S, Hellgren U, Bisoffi Z, Lopez-Velez R, Matteelli A, McWhinney P, Björkman A, Clerinx J, Behrens RH, Gjørup I, Beran J, Schunk M, Zoller T, Probst M, Gascon J, Jelinek T, Mühlberger N, Kern P, Fry G, Siikamaki H, Schulze MH, Soula G, Paul M, Prat J Gómez i, Lehmann V, Bouchaud O, Cunha S da, Atouguia J, Boecken G
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2004
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Indian
• Online Access: https://doi.org/10.1186/1475-2875-3-5; https://doaj.org/article/e6f44cc2c36c4203a553d6c986a05b86

Abstract Background Plasmodium vivax is the second most common species among malaria patients diagnosed in Europe, but epidemiological and clinical data on imported P. vivax malaria are limited. The TropNetEurop surveillance network has monitored the importation of vivax malaria into Europe since 1999. Objectives To present epidemiological and clinical data on imported P. vivax malaria collected at European level. Material and methods Data of primary cases of P. vivax malaria reported between January 1999 and September 2003 were analysed, focusing on disease frequency, patient characteristics, place of infection, course of disease, treatment and differences between network-member countries. Results Within the surveillance period 4,801 cases of imported malaria were reported. 618 (12.9%) were attributed to P. vivax . European travellers and immigrants were the largest patient groups, but their proportion varied among the reporting countries. The main regions of infection in descending order were the Indian subcontinent, Indonesia, South America and Western and Eastern Africa, as a group accounting for more than 60% of the cases. Regular use of malaria chemoprophylaxis was reported by 118 patients. With 86 (inter-quartile range 41–158) versus 31 days (inter-quartile range 4–133) the median symptom onset was significantly delayed in patients with chemoprophylaxis (p < 0.0001). Common complaints were fever, headache, fatigue, and musculo-skeletal symptoms. All patients survived and severe clinical complications were rare. Hospitalization was provided for 60% and primaquine treatment administered to 83.8% of the patients, but frequencies varied strongly among reporting countries. Conclusions TropNetEurop data can contribute to the harmonization of European treatment policies.