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Kotepui M, Kotepui KU, Masangkay FR, Wilairatana P. Evidence of malarial chemoprophylaxis among travellers who died from malaria: a systematic review and meta-analysis. Malar J 2023; 22:359. [PMID: 38001503 PMCID: PMC10675877 DOI: 10.1186/s12936-023-04794-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Chemoprophylaxis is a prevention method for malaria during travel in malaria-endemic countries. This study aimed to collate and synthesize the evidence of malarial chemoprophylaxis among malaria death cases. METHODS Studies documenting malarial chemoprophylaxis related to malaria deaths were searched in PubMed, Scopus, MEDLINE, Embase, and CENTRAL until 3 July 2022. The pooled proportion of malarial chemoprophylaxis among death cases was synthesized using logit transformation and back transformation to a proportion performed using generalized linear mixed models. The pooled log odds ratio (log-OR) with a 95% confidence interval (CI) of malarial chemoprophylaxis in death cases compared to survivors were synthesized. RESULTS Fifty-eight studies were included in the systematic review and the meta-analysis. Of 602 pooled malaria death cases, the number of patients who took chemoprophylaxis was 187 (30%) (95% CI 22-40, P < 0.01, 58 studies), and those who took adequate chemoprophylaxis were 24 (5%) (95% CI 2-13, P < 0.01, 42 studies). A comparable log-OR of underwent chemoprophylaxis was observed between malaria death cases and survivors (P = 0.94, pooled log-OR: - 0.02, 95% CI - 0.46-0.42, I2: 0%, 17 studies). Similarly, a comparable log-OR of adequate chemoprophylaxis was identified between malaria death cases and survivors (P = 0.15, pooled log-OR: 0.83, 95% CI - 0.30-1.97, I2: 47.08%, 11 studies). CONCLUSIONS Among the studies where malarial chemoprophylaxis was reported, approximately 30% of malaria death cases had taken such prophylaxis. Notably, only 5% of these cases adhered fully or adequately to the recommended chemoprophylactic regimen. However, the analysis did not reveal a significant difference in the odds of malarial chemoprophylaxis between malaria death cases and survivors.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | | | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Lu G, Cao Y, Chai L, Li Y, Li S, Heuschen AK, Chen Q, Müller O, Cao J, Zhu G. Barriers to seeking health care among returning travellers with malaria: A systematic review. Trop Med Int Health 2021; 27:28-37. [PMID: 34748264 DOI: 10.1111/tmi.13698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify barriers to seeking health care among returning travellers with malaria with the aim of developing targeted interventions that improve early health care-seeking behaviour, diagnosis and treatment. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review of published medical literature, selecting studies that investigated and reported barriers to seeking health care among returning travellers and migrants with malaria. In total, 633 articles were screened, of which four studies met the inclusion criteria after a full-text review. RESULTS The four studies reported barriers to seeking healthcare among returning travellers in China, the United States, Thailand and the Dominican Republic. Three studies had an observational design. The identified barriers were summarised based on the appraisal delay, illness delay and utilisation delay stages. During appraisal delays, low awareness of malaria was the most significant factor. Once the patient assessed that he or she was ill, belonging to a specific minority ethnicity, being infected with P. vivax and receiving a low level of social support were predictors of delayed health care-seeking. Finally, the most significant factor associated with utilisation delays was the monetary cost. CONCLUSION The health care-seeking behaviour of returning travellers with malaria should be further investigated and improved. Addressing the identified barriers and gaps in health care-seeking behaviour among returning travellers with malaria, particularly among groups at high risk of travel-associated infections, is important to prevent severe disease and deaths as well as secondary transmission and epidemics.
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Affiliation(s)
- Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Liying Chai
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yuping Li
- Department of Neurosurgery, Jiangsu North People's Hospital, Medical College of Yangzhou University, Yangzhou, China
| | - Shuying Li
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | | | - Qi Chen
- Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Olaf Müller
- Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Jun Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
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Zhang SS, Feng J, Zhang L, Ren X, Geoffroy E, Manguin S, Frutos R, Zhou SS. Imported malaria cases in former endemic and non-malaria endemic areas in China: are there differences in case profile and time to response? Infect Dis Poverty 2019; 8:61. [PMID: 31272497 PMCID: PMC6610923 DOI: 10.1186/s40249-019-0571-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/18/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND China has achieved zero indigenous malaria case report in 2017. However, along with the increasing of international cooperation development, there is an increasing number of imported malaria cases from Chinese nationals returning from malaria-affected countries. Previous studies have focused on malaria endemic areas in China. There is thus limited information on non-endemic areas in China, especially on the performance of malaria surveillance and response in health facilities. METHODS A comparative retrospective study was carried out based on routine malaria surveillance data collected from 2013 to 2017. All imported malaria cases reported within the mainland of China were included. Variables used in the comparative analysis between cases in former endemic and former non-endemic areas, included age, gender and occupation, destination of overseas travel, Plasmodium species and patient health outcome. Monthly aggregated data was used to compare seasonal and spatial characteristics. Geographical distribution and spatial-temporal aggregation analyses were conducted. Time to diagnosis and report, method of diagnosis, and level of reporting/diagnosing health facilities were used to assess performance of health facilities. RESULTS A total of 16 733 malaria cases, out of which 90 were fatal, were recorded in 31 provinces. The majority of cases (96.2%) were reported from former malaria endemic areas while 3.8% were reported from former non-malaria endemic areas. Patients in the age class from 19 to 59 years and males made the highest proportion of cases in both areas. There were significant differences between occupational categories in the two areas (P < 0.001). In former endemic areas, the largest proportion of cases was among outdoor workers (80%). Two peaks (June, January) and three peaks (June, September and January) were found in former endemic and former non-endemic areas, respectively. Time between the onset of symptoms and diagnosis at clinics was significantly different between the two areas at different level of health facilities (P < 0.05). CONCLUSIONS All the former non-endemic areas are now reporting imported malaria cases. However, the largest proportion of imported cases is still reported from former endemic areas. Health facilities in former endemic areas outperformed those in former non-endemic areas. Information, treatment, and surveillance must be provided for expatriates while capacity building and continuous training must be implemented at health facilities in China.
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Affiliation(s)
- Shao-Sen Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; WHO Collaborating Center for Tropical Diseases, Shanghai, China
- HydroSciences Montpellier (HSM), Institut de Recherche pour le Développement (IRD), CNRS, Université de Montpellier, 34093 Montpellier, France
- IES Université de Montpellier, CNRS, 34059 Montpellier Cedex 5, France
- Cirad, UMR 17, Intertryp, Campus international de Baillarguet, 34398 Montpellier Cedex 5, France
| | - Jun Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Xiang Ren
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Sylvie Manguin
- HydroSciences Montpellier (HSM), Institut de Recherche pour le Développement (IRD), CNRS, Université de Montpellier, 34093 Montpellier, France
| | - Roger Frutos
- IES Université de Montpellier, CNRS, 34059 Montpellier Cedex 5, France
- Cirad, UMR 17, Intertryp, Campus international de Baillarguet, 34398 Montpellier Cedex 5, France
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; WHO Collaborating Center for Tropical Diseases, Shanghai, China
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Ranaweera D, Kanchana Rajapaksha RMJ, Silva P, Hettiarachchi R, Gunasekera WMKTDAW, Herath H, Fernando D. Severe Plasmodium vivax malaria, HIV, tuberculosis co-infection in a Sri Lankan traveller: case management and challenges during the prevention of malaria reintroduction phase. Malar J 2018; 17:429. [PMID: 30445967 PMCID: PMC6240325 DOI: 10.1186/s12936-018-2581-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/12/2018] [Indexed: 02/04/2023] Open
Abstract
Background The country received malaria-free certification from WHO in September 2016, becoming only the second country in the WHO South East Asia region to be declared malaria-free. Imported malaria cases continue to be reported, with 278 cases reported between 2013 and 2017. The diagnosis of a severe Plasmodium vivax patient co-infected with HIV and tuberculosis is discussed with an overview of the rapid response mounted by the Anti Malaria Campaign (AMC), Sri Lanka. Case presentation A Sri Lankan gem miner who returned from Madagascar on the 6th of April 2018 presented to a private hospital for a malaria diagnostic test on the 21st April, 2 days after the onset of fever. He came on his own for this test due to the awareness he had regarding the risk of imported malaria. As the patient was positive for P. vivax malaria, he was admitted to a government hospital for further management. The patient had features of severe malaria upon admission with a systolic BP < 80 mmHg and thrombocytopaenia (38,000 cells/mm3). Treatment with IV artesunate was initiated immediately and management was carried out rapidly and efficiently by the clinicians with guidance from the staff of the AMC headquarters, which resulted in a rapid recovery of the patient. IV artesunate was followed by a course of artemether plus lumefantrine and the blood smear was negative for malaria by the 2nd day. A 14-day course of primaquine was commenced after excluding a G6PD deficiency. Due to an accidental needle stick injury of a health care worker attending on the patient was tested for HIV and subsequently tuberculosis and was found to be positive for both infections. The patient was discharged on the 1st of May with instructions for follow up visits for malaria. Management of the HIV and tuberculosis infections was attended to by the clinicians and staff of the appropriate disease control programmes (i.e. the national STD/AIDS Control Programme in Sri Lanka and the National Programme for tuberculosis control and chest diseases). Conclusions It is important to consider comorbid conditions and immunosuppression when a patient with a benign form of malaria presents with severe manifestations. Measures should be strengthened to prevent importation of diseases, such as malaria and AIDS through migrant workers who return from high-risk countries.
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Affiliation(s)
- Dewanee Ranaweera
- Anti Malaria Campaign, 555/5 Public Health Building, Narehenpita, Sri Lanka
| | | | - Priyanganie Silva
- Anti Malaria Campaign, 555/5 Public Health Building, Narehenpita, Sri Lanka
| | | | | | - Hemantha Herath
- Anti Malaria Campaign, 555/5 Public Health Building, Narehenpita, Sri Lanka
| | - Deepika Fernando
- Department of Parasitology, Faculty of Medicine, Kynsey Road, Colombo 8, Sri Lanka.
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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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Time delays in the diagnosis and treatment of malaria in non-endemic countries: A systematic review. Travel Med Infect Dis 2018; 21:21-27. [DOI: 10.1016/j.tmaid.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 11/19/2022]
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Effects of a malaria elimination program: a retrospective study of 623 cases from 2008 to 2013 in a Chinese county hospital near the China--Myanmar border. Emerg Microbes Infect 2016; 5:e6. [PMID: 26785944 PMCID: PMC4735059 DOI: 10.1038/emi.2016.6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/18/2015] [Accepted: 10/21/2015] [Indexed: 01/11/2023]
Abstract
The southwestern region of China, along the Myanmar border, has accounted for the highest number of cases of imported malaria since China shifted from a malaria control program to an elimination strategy in 2010. We conducted a retrospective study, in which 623 medical charts were analyzed to provide an epidemiological characterization of malaria cases that were diagnosed and treated at the People's Hospital of Tengchong County (PHTC), located in southwestern China, from 2008 to 2013. Our aim was to understand the characteristics of malaria in this region, which is a high-endemic region with imported cases. The majority of patients were male (91.7%), and the average age was 32.4 years. Most of the patients (86.4%) had visited Myanmar; labor was the purpose of travel for 63.9% of the patients. Plasmodium vivax and Plasmodium falciparum were responsible for 53.8% and 34.9% of the infections, respectively. The number of hospitalized patients rose gradually from 2008 to 2010 and reached its peak in 2010 (191). After 2010, the number of hospitalized cases fell rapidly from 191 (2010) to 45 (2013), and the proportion of patients who lived in the forest and the number infected with P. falciparum also fell. In conclusion, the number of hospitalized patients in the southwestern region of China, Tengchong county, decreased after China implemented a malaria elimination strategy in 2010. However, migrant workers returning from Myanmar remained important contributors to cases of imported malaria. The management of imported malaria should be targeted by the malaria elimination program in China.
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Wesolowski R, Wozniak A, Mila-Kierzenkowska C, Szewczyk-Golec K. Plasmodium knowlesi as a Threat to Global Public Health. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:575-81. [PMID: 26537037 PMCID: PMC4635839 DOI: 10.3347/kjp.2015.53.5.575] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/02/2015] [Accepted: 08/04/2015] [Indexed: 01/06/2023]
Abstract
Malaria is a tropical disease caused by protozoans of the Plasmodium genus. Delayed diagnosis and misdiagnosis are strongly associated with higher mortality. In recent years, a greater importance is attributed to Plasmodium knowlesi, a species found mainly in Southeast Asia. Routine parasitological diagnostics are associated with certain limitations and difficulties in unambiguous determination of the parasite species based only on microscopic image. Recently, molecular techniques have been increasingly used for predictive diagnosis. The aim of the study is to draw attention to the risk of travelling to knowlesi malaria endemic areas and to raise awareness among personnel involved in the therapeutic process.
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Affiliation(s)
- Roland Wesolowski
- The Chair of Medical Biology, Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Alina Wozniak
- The Chair of Medical Biology, Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Celestyna Mila-Kierzenkowska
- The Chair of Medical Biology, Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Karolina Szewczyk-Golec
- The Chair of Medical Biology, Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
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Chen H, Yao L, Zhang L, Zhang X, Lu Q, Yu K, Ruan W. Malaria in Zhejiang Province, China, from 2005 to 2014. Am J Trop Med Hyg 2015; 93:305-309. [PMID: 26078321 PMCID: PMC4530752 DOI: 10.4269/ajtmh.15-0080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/13/2015] [Indexed: 11/27/2022] Open
Abstract
To summarize the changing epidemiological characteristics of malaria in Zhejiang Province, China, we collected data on malaria from the Chinese Notifiable Disease Reporting System (NDRS) and analyzed them. A total of 2,738 malaria cases were identified in Zhejiang Province from 2005 to 2014, of which 2,018 were male and 720 were female. Notably, only 7% of malaria cases were indigenous and the other cases were all imported. The number of malaria cases increased from 2005 to 2007, peaked in 2007, and then decreased from 2007 to 2011. There were no indigenous cases from 2012 to 2014. Of all cases, 68% of cases contracted Plasmodium vivax, 27% of cases contracted P. falciparum, and two cases contracted P. malariae. About 88% of malaria cases during 2005–2011 occurred yearly between May and October, but the number of malaria cases in different months during 2012–2014 was similar. The median age was 33 years, and 1,892 cases occurred in persons aged 20–50 years. The proportion of businessmen increased and the proportion of migrant laborers decreased in recent years. The median time from illness onset to confirmation of malaria cases was 5 days and it decreased from 2005 to 2014. Some epidemiological characteristics of malaria have changed, and businessmen are the emphases to surveillance in every month.
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Affiliation(s)
| | | | | | | | | | | | - Wei Ruan
- *Address correspondence to Wei Ruan, Zhejiang Provincial Center for Disease Control and Prevention, Binsheng Road 3399, Hangzhou 310051, China. E-mail:
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