Volume 17, Number 5—May 2011
CME ACTIVITY
Severe Imported Plasmodium falciparum Malaria, France, 1996–2003
Elise Seringe, Marc Thellier, Arnaud Fontanet, Fabrice Legros, Olivier Bouchaud, Thierry Ancelle, Eric Kendjo, Sandrine Houze, Jacques Le Bras, Martin Danis, Rémy Durand
, and for the French National Reference Center for Imported Malaria Study Group
, and for the French National Reference Center for Imported Malaria Study GroupTable 5
Factors independently associated with severe malaria among patients treated for Plasmodium falciparum malaria in hospitals, France, 1996–2003*
| Variables | Odds ratio (95% confidence interval) | p value |
|---|---|---|
| Age group, y | ||
| <15 | 1 | <0.0001 |
| 16–30 | 0.9 (0.7–1.2) | |
| 31–45 | 1.06 (0.8–1.3) | |
| 46–60 | 1.8 (1.4–2.3) | |
| >60 |
2.7 (2.0–3.6) |
|
| Origin and residence | ||
| African travelers | 1 | <0.0001 |
| African residents | 1.5 (1.1–1.9) | |
| European travelers | 3.2 (2.6–3.8) | |
| European expatriates | 3.7 (2.9–4.9) | |
| Others |
1.9 (1.5–2.6) |
|
| Region of malaria acquisition | ||
| Western Africa | 1 | <0.0001 |
| Central Africa | 0.8 (0.7–0.9) | |
| Eastern Africa | 2.6 (1.7–4.1) | |
| Austral Africa | 1.1 (0.6–2.2) | |
| Madagascar and Comoros Islands | 0.7 (0.5–0.9) | |
| Others |
0.9 (0.6–1.5) |
|
| Chemoprophylaxis | ||
| Appropriate drugs† | 1 | 0.001 |
| No chemoprophylaxis | 1.3 (1.1–1.5) | |
| Inappropriate drugs‡ |
1.5 (1.2–1.9) |
|
| Place of first visit | ||
| Hospital | 1 | |
| General practitioner |
1.4 (1.2–1.7) |
<0.0001 |
| Time between onset and diagnosis, d | ||
| <1 | 1 | <0.0001 |
| 2–3 | 0.9 (0.8–1.2) | |
| 4–6 | 1.6 (1.3–1.9) | |
| 7–12 | 1.5 (1.1–1.8) | |
| >12 |
0.7 (0.5–0.9) |
|
| Symptom onset | ||
| After return to France | 1 | |
| Before return to France |
1.2 (1.01–1.5) |
0.03 |
| Season of diagnosis | ||
| Spring–summer | 1 | |
| Fall–winter | 1.3 (1.2–1.5) | <0.0001 |
*N = 21,888.
†Appropriate chemoprophylactic drugs were mefloquine, atovaquone-proguanil, doxycycline, and chloroquine-proguanil.
‡According to national recommendations, inappropriate chemoprophylactic drugs were chloroquine, proguanil, pyrimethamine, and sulfadoxine-pyrimethamine.
1Additional members of the French National Reference Center for Imported Malaria Study Group who contributed data are listed in the Technical Appendix.
