[Current data on malaria in metropolitan France].

Epidemiological data from the French National Reference Center for Imported Diseases showed that the estimated number of cases of imported malaria in France increased from 5,940 in 1998 to 7,127 in 1999 and 8,056 in 2000. This three-year progression ended in 2001 when the number of estimated cases fell back to 7,223. It was due mainly to the concomitant increase in the number of people traveling to endemic zones especially in Africa. In 2000 the median age of patients with imported malaria in France was 29.5 years and the sex ratio was 1.78. Sixty-three percent of cases involved people of African origin and 37% involved "Westerners". The countries in which contamination occurred were located in tropical Africa (95%), Asia (2.2%), and Latin America (2.7%). During the three year period from 1998 to 2000, there were a total of 13 accidental autochtonous cases of malaria involving patients with no history of travel to tropical areas. The distribution of Plasmodium species involved in imported malaria in France was stable with 83% of cases involving Plasmodium falciparum, 6% involving Plasmodium vivax, 6.5% involving Plasmodium ovale and 1.3% involving Plasmodium malariae. Attacks were clinically uncomplicated in 90 to 95% of cases and severe in 2 to 5% including fatal Plasmodium falciparum malaria in 0.49 to 0.37% of cases. Less than 10% of the 45% of patients claiming use of prophylaxis complied properly. Analysis of the drugs used for curative treatment in 2000 showed an increase in the use of quinine and mefloquine and decrease in the use of halofantrine. The main objectives remain reduction of mortality and improvement of prevention.