Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA, 30329, USA.
McGill University Centre for Tropical Diseases, Montreal, Canada.
Malar J. 2017 Jul 20;16(1):293. doi: 10.1186/s12936-017-1936-3.
More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation.
Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria.
There were 5689 travellers included; 325 were children <18 years. More than half (53%) were visiting friends and relatives (VFRs). Most (83%) were exposed in sub-Saharan Africa. The median trip duration was 32 days (interquartile range 20-75); 53% did not have a pre-travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died.
Malaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized.
每年有超过 30000 例疟疾病例报告给国际旅行者。尽管疟疾控制有所改善，但由于对风险的不准确认知和旅行前准备不足，疟疾继续威胁着旅行者。
从 2003 年 1 月至 2016 年 7 月，从 GeoSentinel（一个监测与旅行和热带医学相关发病率的全球旅行医学监测网络）获取了旅行后确诊疟疾的记录。如果暴露国家缺失或无法确定，或者存在与疟疾无关的急性合并诊断，则排除该记录。对记录进行分析，以描述患有疟疾的国际旅行者的人口统计学和临床特征。
共有 5689 名旅行者入选；325 名旅行者为<18 岁的儿童。超过一半（53%）是探亲访友旅行者（VFR）。大多数（83%）旅行者在撒哈拉以南非洲地区暴露。旅行期间中位数为 32 天（四分位间距 20-75）；53%的旅行者未进行旅行前咨询。超过一半（62%）的旅行者住院治疗；儿童住院率高于成年人（分别为 73%和 62%）。92%的旅行者被诊断为单一的疟原虫物种，最常见的是恶性疟原虫（4011；76%）。感染恶性疟原虫的旅行者多为探亲访友旅行者（60%）。在旅行时间≤7 天的旅行者中，超过 40%的旅行者感染了间日疟原虫。有 444 名（8%）旅行者患有重症疟疾；31 名儿童患有重症疟疾。有 12 名旅行者死亡。
疟疾仍然是国际旅行者的严重威胁。必须将重点放在针对儿童和探亲访友旅行者的预防策略上，并且应强调化学预防的获取和预防措施的遵守。
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