F Talarmin1, J M Sicard, M Mounem, D Verrot, J A Husser. 1. Service de médecine interne et pathologie infectieuse et tropicale, hôpital d'instruction des armées Legouest, Metz-Armées, France.
Abstract
PURPOSE: Imported malaria frequency is increasing in France. Moselle, a north-east French county, with high concentration of servicemen going in endemic areas, follows the same trend. METHODS: Clinical, epidemiological aspects and treatment of all malaria attacks diagnosed over 3 years (from 1st january 1996 to 31st january 1999) were studied. Data pertaining to antimalaria prophylaxis and the reasons for prophylaxis failure were analyzed. RESULTS: Seventy-five patients developed a paroxysmal episode of malaria. No severe malaria and no death were noted. Ninety-six percent of the patients came from Africa (96%), 64% of them coming from western Africa (Ivory coast, Senegal, and Togo). Plasmodium falciparum was responsible for 90% of the cases. Giemsa staining, quantitative buffy coat diagnosis system and parasight rapid dipstick antigen capture assay help guide diagnosis. Halofantrine (64%) and quinine (28.6%) were used as curative treatment. Investigation about prophylactic means showed than 37.9% of interviewed patients did not comply with the preventive treatment. The primary prophylaxis (avoiding bites) was in existent or badly done. CONCLUSION: Although the best choice for chemoprophylaxis is still debated, travelers going to endemic areas should be aware of the risks for malaria and persuaded to take a preventive treatment, even though its efficacy may not be complete. They also should wear insecticide-treated clothes in order to decrease the number of potentially infective mosquito bites.
PURPOSE: Imported malaria frequency is increasing in France. Moselle, a north-east French county, with high concentration of servicemen going in endemic areas, follows the same trend. METHODS: Clinical, epidemiological aspects and treatment of all malaria attacks diagnosed over 3 years (from 1st january 1996 to 31st january 1999) were studied. Data pertaining to antimalaria prophylaxis and the reasons for prophylaxis failure were analyzed. RESULTS: Seventy-five patients developed a paroxysmal episode of malaria. No severe malaria and no death were noted. Ninety-six percent of the patients came from Africa (96%), 64% of them coming from western Africa (Ivory coast, Senegal, and Togo). Plasmodium falciparum was responsible for 90% of the cases. Giemsa staining, quantitative buffy coat diagnosis system and parasight rapid dipstick antigen capture assay help guide diagnosis. Halofantrine (64%) and quinine (28.6%) were used as curative treatment. Investigation about prophylactic means showed than 37.9% of interviewed patients did not comply with the preventive treatment. The primary prophylaxis (avoiding bites) was in existent or badly done. CONCLUSION: Although the best choice for chemoprophylaxis is still debated, travelers going to endemic areas should be aware of the risks for malaria and persuaded to take a preventive treatment, even though its efficacy may not be complete. They also should wear insecticide-treated clothes in order to decrease the number of potentially infective mosquito bites.