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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 DurandComments to Author , and for the French National Reference Center for Imported Malaria Study Group
Author affiliations: Author affiliations: University Pierre et Marie Curie, Paris, France (E. Seringe, M. Thellier, M. Danis); Groupe Hospitalier Pitié-Salpĕtrière, Paris (E. Seringe, M. Thellier, M. Danis); Centre National de Référence du Paludisme, Paris (M. Thellier, F. Legros, E. Kendjo, S. Houze, J. Le Bras, M. Danis, R. Durand); Institut Pasteur, Paris (E. Seringe, A. Fontanet); Conservatoire National des Arts et Métiers, Paris (A. Fontanet); Hôpital Avicenne, Bobigny, France (O. Bouchaud, R. Durand); Hôpital Cochin, Paris (T. Ancelle)

Main Article

Table 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.

Main Article

1Additional members of the French National Reference Center for Imported Malaria Study Group who contributed data are listed in the Technical Appendix.

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