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Oceane Minka S, Cottrell G, Cot M, Hillary Minka F, Thellier M, Choquet C, Houze S. New guidelines reduce the risk of hospitalization for adult patients with uncomplicated Plasmodium falciparum malaria: An observational, multicenter, retrospective French study. Infect Dis Now 2024; 54:104963. [PMID: 39173714 DOI: 10.1016/j.idnow.2024.104963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 08/05/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES We aimed to evaluate the impact of malaria declaration year (before or after 2017) on the frequency of hospitalization in metropolitan France of patients with uncomplicated non-vomiting P.falciparum malaria. PATIENTS AND METHODS An observational, multicenter, retrospective study was carried out, using the database from the French National Reference Centre for Malaria. Descriptive analysis and multivariate analysis by logistic regression were performed using the multiple imputation by chained equation method to handle missing data. RESULTS More than 2000 (2184) uncomplicated non-vomiting P.falciparum malaria cases were recorded. Our multivariate analysis showed an association between the year 2018 and reduced risk of hospitalization (OR: 0.89; 95% CI: 0.81-0.97). CONCLUSION Compared to 2016, during 2018 we observed a trend toward ambulatory care for patients presenting with uncomplicated non-vomiting P.falciparum malaria.
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Affiliation(s)
- Sally Oceane Minka
- Centre Hospitalier Universitaire de Bichat, Service des Urgences, 75018 Paris, France; Université Paris Cité, 75006 Paris, France.
| | | | - Michel Cot
- Faculté de pharmacie, IRD, UMR-MERIT, 75006 Paris, France
| | - Fadi Hillary Minka
- Centre Hospitalier Universitaire de Lariboisière, Service des Urgences, 75010 Paris, France; Université Paris Cité, 75006 Paris, France
| | - Marc Thellier
- Centre Hospitalier Universitaire de la Pitié Salpétrière, CNR du Paludisme, 75013 Paris, France; Université Sorbonne Paris Nord, 75013 Paris, France
| | - Christophe Choquet
- Centre Hospitalier Universitaire de Bichat, Service des Urgences, 75018 Paris, France
| | - Sandrine Houze
- Faculté de pharmacie, IRD, UMR-MERIT, 75006 Paris, France; Centre Hospitalier Universitaire de Bichat, CNR du Paludisme, 75018 Paris, France
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Agagliati F, Silvestro E, Denina M, Garazzino S, Mignone F, Zoppo M, Pruccoli G, Scolfaro C. Imported malaria in children: A 13 years retrospective study. Travel Med Infect Dis 2022; 46:102273. [DOI: 10.1016/j.tmaid.2022.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/15/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
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Comelli A, Guarner ME, Tomasoni LR, Fanetti Zamboni A, Moreno Pavón B, Zanotti P, Caligaris S, Matteelli A, Soriano-Arandes A, Castelli F. Severe imported Plasmodium falciparum malaria in children: characteristics and useful factors in the risk stratification. Travel Med Infect Dis 2021; 44:102196. [PMID: 34748988 DOI: 10.1016/j.tmaid.2021.102196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 08/09/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Severe imported pediatric malaria is of concern in non-endemic settings. We aimed to determine the features of pediatric severe cases in order to design a model able to stratify patients at presentation. METHODS We conducted a retrospective cross-sectional study including all imported P. falciparum malaria infection in patients ≤14 years of age, treated from January 2008 to February 2019 in two tertiary hospitals: Brescia, Italy and Barcelona, Spain. Severe malaria was defined according to World Health Organization criteria. Mortality rate, pediatric intensive care unit (PICU) stay and blood transfusion were analysed as adverse outcomes. RESULTS Out of 139 children included, 30.9% were severe malaria. Twenty-seven (19.4%) were admitted to PICU, and transfusion was required in 14 cases (10.1%). Predictors for severe malaria were: young age, low hemoglobin, high white blood cells (WBC) and high C-reactive protein. Platelet <130,000/μl correlated with severe malaria (without statistical significance). A model that includes age, WBC and C-reactive protein shows a high specificity to classify patients without severe malaria (92.3%) with 70% PPV and 75% NPV. CONCLUSIONS A score based on patient's age, WBC and C-reactive protein easily available at emergency room can help to identify children with higher risk of adverse outcomes.
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Affiliation(s)
- Agnese Comelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
| | - María Espiau Guarner
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron. PROSICS Barcelona. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Lina Rachele Tomasoni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Agnese Fanetti Zamboni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Belén Moreno Pavón
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron. PROSICS Barcelona. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Paola Zanotti
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Silvio Caligaris
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Alberto Matteelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron. PROSICS Barcelona. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy
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Amoah LE, Donu D, Abuaku B, Ahorlu C, Arhinful D, Afari E, Malm K, Koram KA. Probing the composition of Plasmodium species contained in malaria infections in the Eastern region of Ghana. BMC Public Health 2019; 19:1617. [PMID: 31791319 PMCID: PMC6889690 DOI: 10.1186/s12889-019-7989-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/21/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Asymptomatic falciparum and non-falciparum malaria infections are major challenges to malaria control interventions, as they remain a source of continual infection in the community. This becomes even more important as the debate moves towards elimination and eradication. This study sought to quantify the burden of Plasmodium malaria infection in seven communities in the Eastern Region of Ghana. METHODS The cross-sectional study recruited 729 participants aged 85 years old and below from 7 closely linked communities. Finger pricked blood was used to prepare thick and thin blood smears as well as spot filter paper and an histidine rich protein 2 (HRP2) rapid diagnostic test kit (RDT). Genomic DNA was extracted from the filter paper dry blood spot (DBS) and used in PCR to amplify the Plasmodium 18S rRNA gene using species specific PCR. RESULTS 96.6% of the participants were identified as afebrile, with axillary temperatures below 37.5 °C. PCR identified 66% of the participants to harbor malaria parasites, with 9 P. malariae and 7 P. ovale mono-infections accounting for 2.2% and P. falciparum combined with either 36 P. malariae or 25 P. ovale infections, accounting for 13.3%. Parasite prevalence by microscopy (32%) was similar to the RDT positivity rate (33%). False positive RDT results ranged from 64.6% in children aged between 5 and 9 years to 10% in adults aged 20 years and above. No significant differences were observed in falciparum and non-falciparum parasite carriage at the community level, however young adults aged between 15 and 19 years had the highest prevalence (34.8% (16/46)) of P. falciparum and P. malariae parasite carriage whilst children aged between 5 and 9 years had the highest level (11.4% (14/123)) of P. ovale carriage. CONCLUSION The high rate of misidentification of non-falciparum parasites and the total absence of detection of P. ovale by microscopy suggests that more sensitive malaria diagnostic tools including molecular assays are required to accurately determine the prevalence of carriers of non-falciparum parasites and low density P. falciparum infections, especially during national surveillance exercises. Additionally, malaria control interventions targeting the non-falciparum species P. malariae and P. ovale parasites are needed.
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Affiliation(s)
- Linda Eva Amoah
- Immunology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana. .,West Africa Center for Cell biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana.
| | - Dickson Donu
- Immunology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Benjamin Abuaku
- Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Colins Ahorlu
- Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Daniel Arhinful
- Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Edwin Afari
- School of Public Health, University of Ghana, Accra, Ghana
| | - Keziah Malm
- National Malaria Control Program, Accra, Ghana
| | - Kwadwo Ansah Koram
- West Africa Center for Cell biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana.,Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Epidemiological and etiological features of travel-related febrile illnesses in hospitalized Russian children and adults: A single-centre, retrospective analysis in Moscow. Travel Med Infect Dis 2019; 34:101447. [PMID: 31284068 DOI: 10.1016/j.tmaid.2019.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND A number of factors can lead to differences in infectious disease morbidity in children versus adults after a trip abroad. We aimed to investigate the epidemiological and etiological features of infectious diseases in children after international travel. METHODS we analyzed the medical records of 2135 patients (416 children) who were hospitalized during the period 2009-2017 after return from international travel. RESULTS Hospitalized children were under the age of 1 year in 8.7% of cases, 1-3 years - 39.4%, 4-6 years - 17.3%, 7-11 years - 16.8%, 12-17 years - 17.8%. Children were hospitalized after visiting the following main destinations: Turkey (15%), Egypt (12%), Central Asia microregion [11%] and Thailand (9%). Hospitalizations among children occurred mainly in summer (38.0%; CI 33.3-42.4). In adults there were no significant seasonal differences. Children were more likely to have acute diarrhea (18.3 vs 11.1%), acute respiratory tract infections (51.2 vs 41.2%) and enterovirus infections (8.2 vs 3.1%). Among the non-endemic infections for Russia, 8 children were diagnosed with dengue fever, 1 with typhoid, 1 with malaria, and 1 with wild-poliovirus excretion. CONCLUSION children were mainly hospitalized during summer. Among hospitalized children, almost half was under 3 years old. In children acute respiratory infection and intestinal infections predominated, while in adults, vector-borne diseases were more frequently observed.
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Panin F, Orlandini E, Galli L, De Martino M, Chiappini E. Increasing imported malaria in children and adults in Tuscany, Italy, (2000 to 2017): A retrospective analysis. Travel Med Infect Dis 2019; 29:34-39. [DOI: 10.1016/j.tmaid.2019.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 03/17/2019] [Accepted: 03/28/2019] [Indexed: 11/15/2022]
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Leblanc C, Vasse C, Minodier P, Mornand P, Naudin J, Quinet B, Siriez JY, Sorge F, de Suremain N, Thellier M, Kendjo E, Faye A, Imbert P. Management and prevention of imported malaria in children. Update of the French guidelines. Med Mal Infect 2019; 50:127-140. [PMID: 30885541 DOI: 10.1016/j.medmal.2019.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 02/18/2019] [Indexed: 01/09/2023]
Abstract
Since the 2007 French guidelines on imported Falciparum malaria, the epidemiology, treatment, and prevention of malaria have changed considerably requiring guidelines for all Plasmodium species to be updated. Over the past decade, the incidence of imported malaria has decreased in all age groups, reflecting the decrease in the incidence of malaria in endemic areas. The rates of severe pediatric cases have increased as in adults, but fatalities are rare. The parasitological diagnosis requires a thick blood smear (or a rapid immunochromatographic test) and a thin blood film. Alternatively, a rapid antigen detection test can be paired with a thin blood film. Thrombocytopenia in children presenting with fever is highly predictive of malaria following travel to a malaria-endemic area and, when detected, malaria should be strongly considered. The first-line treatment of uncomplicated P. falciparum malaria is now an artemisinin-based combination therapy (ACT), either artemether-lumefantrine or artenimol-piperaquine, as recommended by the World Health Organization in endemic areas. Uncomplicated presentations of non-falciparum malaria should be treated either with chloroquine or ACT. The first-line treatment of severe malaria is now intravenous artesunate which is more effective than quinine in endemic areas. Quinine is restricted to cases where artesunate is contraindicated or unavailable. Prevention of malaria in pediatric travelers consists of nocturnal personal protection against mosquitoes (especially insecticide-treated nets) combined with chemoprophylaxis according to the risk level.
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Affiliation(s)
- C Leblanc
- Pédiatrie générale et maladies infectieuses, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - C Vasse
- Accueil des urgences pédiatriques, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - P Minodier
- Urgences enfants, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - P Mornand
- Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Service de pédiatrie et aval des urgences, hôpital d'Enfants A. Trousseau, 26, avenue du docteur Arnold-Netter, 75012 Paris, France
| | - J Naudin
- Réanimation pédiatrique, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - B Quinet
- Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Service de pédiatrie et aval des urgences, hôpital d'Enfants A. Trousseau, 26, avenue du docteur Arnold-Netter, 75012 Paris, France
| | - J Y Siriez
- Accueil des urgences pédiatriques, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - F Sorge
- Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Service de pédiatrie générale, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France
| | - N de Suremain
- Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Service de pédiatrie et aval des urgences, hôpital d'Enfants A. Trousseau, 26, avenue du docteur Arnold-Netter, 75012 Paris, France
| | - M Thellier
- Centre national de référence du paludisme, service de parasitologie-mycologie, hôpital Pitié-Salpêtrière, 43-87, boulevard de l'Hôpital, 75013 Paris, France
| | - E Kendjo
- Centre national de référence du paludisme, service de parasitologie-mycologie, hôpital Pitié-Salpêtrière, 43-87, boulevard de l'Hôpital, 75013 Paris, France
| | - A Faye
- Pédiatrie générale et maladies infectieuses, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
| | - P Imbert
- Groupe de pédiatrie tropicale de la Société française de pédiatrie, pédiatrie générale, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Centre de vaccinations internationales, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
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Antinori S, Napolitano M, Grande R, Passerini S, Ridolfo AL, Galimberti L, Oreni L, Schinaia S, Milazzo L, Galli M, Corbellino M, Gismondo MR, Zanchetta N, Cordier L, Rizzardini G. Epidemiological and clinical characteristics of imported malaria in adults in Milan, Italy, 2010-2015. Eur J Intern Med 2018; 57:e13-e16. [PMID: 30064716 DOI: 10.1016/j.ejim.2018.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 07/25/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Maria Napolitano
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Romualdo Grande
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergent Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Simone Passerini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Galimberti
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Letizia Oreni
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Sara Schinaia
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Massimo Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Maria Rita Gismondo
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergent Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Nadia Zanchetta
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergent Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Cordier
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
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