1921
Volume 75, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Despite sophisticated intensive medicine, between one and three malaria-associated deaths occur annually in Switzerland. In this retrospective study, 33 deaths (25 men and 8 women) caused by falciparum malaria reported in Switzerland from 1988 to 2002 were analyzed. The case fatality ratio (CFR) for the falciparum infections for the 15-year period was 1.2%, with a peak of 2.2% in 1991. Sub-Saharan Africa was the source of all the imported fatal infections. Non-immune Europeans had a significantly higher case fatality ratio than the non-Europeans (1.7% versus 0.2%; < 0.001). Careless use or non-use of prophylaxis, sometimes because of physicians giving unsatisfactory pre-travel advice, and initially missed diagnosis post-travel were factors that contributed to the development of severe infections leading to death. Travelers should be sensitized to the risk of malaria by well-informed general practitioners. Updated information is readily available (www.safetravel.ch). Regarding diagnosis and treatment, greater physician awareness of the disease is needed, and expert advice should be sought without hesitation. Rapid malaria tests may be a useful diagnostic adjunct in centers where microscopic expertise is lacking. Falciparum malaria in a non-immune patient is an emergency requiring immediate treatment.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2006.75.1188
2006-12-01
2017-09-26
Loading full text...

Full text loading...

/deliver/fulltext/14761645/75/6/0751188.html?itemId=/content/journals/10.4269/ajtmh.2006.75.1188&mimeType=html&fmt=ahah

References

  1. World Health Organization, 1996. International notes: Airport malaria—Switzerland. World Health Organ Wkly Epidemol Rep 71 : 358.
  2. Frey-Wettstein M, Maier A, Markwalder K, Münch U, 2001. A case of transfusion transmitted malaria in Switzerland. Swiss Med Wkly 131 : 320.
  3. Muentener P, Schlagenhauf P, Steffen R, 1999. Imported malaria (1985–95): Trends and perspectives. Bull World Health Organ 77 : 560–566.
  4. Sabatinelli G, Ejov M, Joergensen P, 2001. Malaria in the WHO European Region (1971–1999). Eurosurveillance Monthly 6 : 61–65.
  5. Lobel HO, Philips-Howard PA, Brandling-Bennett AD, Steffen R, Campbell CC, Huong AY, Were JB, Moser R, 1990. Malaria incidence and prevention among European and North American travelers to Kenya. Bull World Health Organ 64 : 209–215.
  6. Matteelli A, Colombini P, Gulletta M, Castelli F, Carosi G, 1999. Epidemiological features and case management practices of imported malaria in northern Italy 1991–1995. Trop Med Int Health 4 : 653–657.
  7. Muhlberger N, Jelinek T, Behrens RH, Gjorup I, Coulaud JP, Clerinx J, Puente S, Burhard G, Gascon J, Grobusch MP, Weitzel T, Zoller T, Kollaritsch H, Beran J, Iversen J, Hatz C, Schmid ML, Bjorkman A, Fleischer K, Bisoffi Z, Guggemos W, Knobloch J, Matteelli A, Schulze MH, Laferl H, Kapaun A, Mc Whinney P, Lopez-Velez R, Fatkenheuer G, Kern P, Zieger BW, Kotlowski A, Fry G, Cuadros J, Myrvang B, 2003. Age as a risk factor for severe manifestations and fatal outcome of falciparum malaria in European patients: Observations from TropNetEurop and SIMPID Surveillance Data. Clin Infect Dis 36 : 990–995.
  8. Hatz C, Krause E, Grundmann H, 1997. Travel advice: a study among Swiss and German general practitioners. Trop Med Int Health 2 : 6–12.
  9. Schlagenhauf P, Tschopp A, Johnson R, Nothdurft HD, Beck B, Schwartz E, Herold M, Krebs B, Veit O, Allwinn R, Steffen R, 2003. Tolerability of malaria chemoprophylaxis in non-immune travellers to sub-Saharan Africa: Multicentre, randomised, double-blind, four arm study. BMJ 327 : 1078–1081.
  10. Reid AJC, Whitty CJM, Ayles HM, Jennings RM, Bovill BA, Felton JM, Behrens RH, Bryceson ADM, Mabey DCW, 1998. Malaria at Christmas: Risk of prophylaxis versus risks of malaria. BMJ 317 : 1506–1508.
  11. Marx A, Pewsner D, Egger M, Nuesch R, Bucher H, Genton B, Hatz C, Juni P, 2005. Meta-Analysis: Accuracy of rapid tests for malaria in travelers returning from endemic areas. Ann Intern Med 142 : 836–846.
  12. D’Acremont V, Landry P, Mueller I, Pécoud A, Genton B, 2002. Clinical and laboratory predictors of imported malaria in an outpatient setting: An aid to medical decision making in returning travellers with fever. Am J Trop Med Hyg 66 : 481–486.
  13. Kain KC, Harrington MA, Tennyson S, Keystone JS, 1998. Imported malaria: Prospective analysis of problems in diagnosis and management. Clin Infect Dis 27 : 142–149.
  14. Lehky Hagen M, 2002. Problematik der importierten Malaria in der Schweiz. Eine Analyse der gemeldeten Malariafälle aus Kenia von 1988–1996. MD Thesis, University of Basel, Basel, Switzerland.
  15. Newman RD, Parise ME, Barber AM, Steketee RW, 2004. Malaria-related deaths among U.S. travelers, 1963–2001. Ann Intern Med 141 : 547–555.
  16. Isaäcson M, Frean JA, 2001. Odyssean and non-mosquito-transmitted forms of malaria. Schlagenhauf P, ed. Travelers’ Malaria. Hamilton, Canada: Decker BC, 463–473.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2006.75.1188
Loading
/content/journals/10.4269/ajtmh.2006.75.1188
Loading

Data & Media loading...

  • Received : 16 Jun 2005
  • Accepted : 19 Jul 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error