Research Article
How should Travel-Related Malaria Management in Emergency Departments of Non-endemic Countries? Single-center Study
Abstract
Purpose: Advancements in air travel enabled an increase in traveling to malaria-endemic countries such as those in sub-Saharan Africa. An increase in the incidence of imported malaria accompanied these advancements. This study aims to summarize how malaria patients who have imported the disease into non-endemic countries present to the emergency departments and to enlighten physicians in emergency departments by providing suggestions for practical approaches to handling such situations.
Methods: This study was conducted retrospectively in a university hospital, from January 1, 2014 to March 1, 2022. Seven years of emergency department records of patients who were examined in the emergency department with a suspected, or definitive diagnosis of malaria were included in the study. Epidemiological and clinical characteristics were evaluated.
Results: 892 patients were admitted to the emergency department with suspicion of malaria. Thirty of these patients were diagnosed with malaria, and 846 of the 892 patients were members of airline cabin crews. 94.3% (n=798) of the cabin crew did not use prophylactic medication for malaria. The mean age of the patients was 33.2±8.5. Twenty-five patients were diagnosed via peripheral blood smears, and the remaining three patients were diagnosed with PCR. Rapid diagnostic tests were positive in 26 out of 28 patients.
Conclusion: The risk of acquiring malaria is still high despite short-term visits and airport-limited stays. Travel history should be routinely asked of patients by emergency physicians. Education of people traveling to malaria-endemic countries, including cabin crew, regarding malaria prophylaxis and protective measures to prevent mosquito bites plays a crucial role in preventing malaria.
References
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Year 2022,
Volume: 13 Issue: 4, 476 - 483, 01.10.2022
Abstract
References
- Shellvarajah M, Hatz C, Schlagenhauf P. Malaria prevention recommendations for risk groups visiting sub-Saharan Africa: A survey of European expert opinion and international recommendations. Travel Med Infect Dis. 2017;19:49-55. doi:10.1016/j.tmaid.2017.09.002
- World malaria report 2020: 20 years of global progress and challenges. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO
- Gething PW, Patil AP, Smith DL, et al. A new world malaria map: Plasmodium falciparum endemicity in 2010. Malar J. 2011;10:378. Published 2011 Dec 20. doi:10.1186/1475-2875-10-378
- Centers for Disease Control and Prevention (CDC): Malaria and Travelers. Choosing a Drug to Prevent Malaria. Available from: http://www.cdc.gov/malaria/travelers/drugs.html
- Interview with Dr Abdisalan Noor, Team Leader of the WHO Global Malaria Programme's Surveillance Unit and lead author of the World malaria report 2019
- Varo R, Balanza N, Mayor A, et al. Diagnosis of clinical malaria in endemic settings. Expert Rev Anti Infect Ther. 2021;19(1):79-92. doi:10.1080/14787210.2020.1807940
- Tatem AJ, Jia P, Ordanovich D, et al. The geography of imported malaria to non-endemic countries: a meta-analysis of nationally reported statistics. Lancet Infect Dis. 2017;17(1):98-107. doi:10.1016/S1473-3099(16)30326-7
- Lewis J, Gregorian T, Portillo I, et al. Drug interactions with antimalarial medications in older travelers: a clinical guide. J Travel Med. 2020;27(1):taz089. doi:10.1093/jtm/taz089
- Throckmorton L, Hancher J. Management of Travel-Related Infectious Diseases in the Emergency Department. Curr Emerg Hosp Med Rep. 2020;8(2):50-59. doi:10.1007/s40138-020-00213-6
- Lee YW, Choi JW, Shin EH. Machine learning model for predicting malaria using clinical information. Comput Biol Med. 2021;129:104151. doi:10.1016/j.compbiomed.2020.104151
- Ahluwalia J, Brooks SK, Weinman J, et al. A systematic review of factors affecting adherence to malaria chemoprophylaxis amongst travellers from non-endemic countries. Malar J. 2020;19(1):16. Published 2020 Jan 13. doi:10.1186/s12936-020-3104-4
- Tatem AJ, Rogers DJ, Hay SI. Estimating the malaria risk of African mosquito movement by air travel. Malar J. 2006;5:57. Published 2006 Jul 14. doi:10.1186/1475-2875-5-57
- Simons R, Valk PJ, Krul AJ. Malaria prophylaxis for aircrew: safety of atovaquone/proguanil in healthy volunteers under aircraft cabin pressure conditions. J Travel Med. 2005;12(4):210-216. doi:10.2310/7060.2005.12407
- Centers for Disease Control and Prevention (2019) CDC - Malaria - Diagnosis & Treatment (United States) - Treatment (U.S.). In: Centers for Disease Control and Prevention. https://www.cdc.gov/ malaria/diagnosis_treatment/treatment.html. Jan 2020.
- Chen LH, Wilson ME, Davis X, et al. Illness in long-term travelers visiting GeoSentinel clinics. Emerg Infect Dis. 2009;15(11):1773-1782. doi:10.3201/eid1511.090945
- Chen LH, Wilson ME, Schlagenhauf P. Prevention of malaria in long-term travelers. JAMA. 2006;296(18):2234-2244. doi:10.1001/jama.296.18.2234
- Colucci B, Müller P. Evaluation of standard field and laboratory methods to compare protection times of the topical repellents PMD and DEET. Sci Rep. 2018;8(1):12578. Published 2018 Aug 22. doi:10.1038/s41598-018-30998-2
- Checkley AM, Smith A, Smith V, et al. Risk factors for mortality from imported falciparum malaria in the United Kingdom over 20 years: an observational study. BMJ. 2012;344:e2116. Published 2012 Mar 27. doi:10.1136/bmj.e2116
- Christen D, Steffen R, Schlagenhauf P. Deaths caused by malaria in Switzerland 1988-2002. Am J Trop Med Hyg. 2006;75(6):1188-1194.
- Centers for Disease Control and Prevention (CDC): Malaria Diagnosis & Treatment in the United States. Available from: https://www.cdc.gov/malaria/diagnosis_treatment/index.html
- Zodda D, Procopio G, Hewitt K, et al. Severe malaria presenting to the ED: A collaborative approach utilizing exchange transfusion and artesunate. Am J Emerg Med. 2018;36(6):1126.e1-1126.e4. doi:10.1016/j.ajem.2018.03.023
- Galatas B, Mayor A, Gupta H, et al. Field performance of ultrasensitive and conventional malaria rapid diagnostic tests in southern Mozambique. Malar J. 2020;19(1):451. Published 2020 Dec 7. doi:10.1186/s12936-020-03526-9
There are 22 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Emergency Medicine |
| Journal Section | Research Article |
| Authors | |
| Publication Date | October 1, 2022 |
| Submission Date | April 13, 2022 |
| Published in Issue | Year 2022Volume: 13 Issue: 4 |
