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Volume 13, Number 6—June 2007


Risk Factors for Imported Fatal Plasmodium falciparum Malaria, France, 1996–2003

Fabrice Legros*†‡§, Olivier Bouchaud¶, Thierry Ancelle#**, Amandine Arnaud*†, Sandrine Cojean#††, Jacques Le Bras¶#††, Martin Danis*†§‡‡, Arnaud Fontanet§§, Rémy Durand††¶Comments to Author , Autochthonous Malaria Epidemiology, and for the French National Reference Centers for ImportedChemosensitivity Working Group
Author affiliations: *Centre National de Référence de l'Epidémiologie du Paludisme d'Importation et Autochtone, Paris, France; †University Pierre et Marie Curie, Paris, France; ‡Institut de Recherche pour le Développement, Paris, France; §Institut National de la Santé et de la Recherche Medicalé, U511, Paris, France; ¶Hôpital Avicenne and University Paris 13, Bobigny, France; #University Paris 5, Paris, France; **Hôpital Cochin; Paris, France; **Hôpital Cochin; Paris, France; ††Centre National de Référence pour la Chimiosensibilité du Paludisme Hôpital Bichat-Claude Bernard, Paris, France; ‡‡Groupe Hospitalier Pitié-Salpêtrière, Paris France; §§Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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Table 4

Factors independently associated with deaths among patients treated for falciparum malaria in French hospitals, 1996–2003 (n = 21,888)*

Variable Odds ratio 95% Confidence interval p value
Per increase of 10 y 1.78 (1.56–2.02) <0.001
Origin and residence
African travelers 1
African residents 3.15 (1.32–7.51)
European travelers 6.79 (3.49–13.2) <0.001
European expatriates 4.44 (1.91–10.3)
Others 3.02 (1.21–7.57)
Region of malaria acquisition
West Africa 1
Central Africa 0.86 (0.52–1.41)
East Africa 3.39 (1.49–7.72) 0.02
Madagascar and Comoros Islands 0.61 (0.24–1.53)
Others 0.47 (0.11–1.95)
Effective drugs† 1
No chemoprophylaxis 2.07 (1.19–3.61) 0.04
Ineffective drugs† 1.90 (0.91–3.95)

*Multiple imputations were used for missing data for the variables “region of malaria acquisition” (n = 9) and “chemoprophylaxis” (n = 2,366) (see Methods).
†Effective drugs were mefloquine, atovaquone-proguanil, doxycycline, and chloroquine-proguanil; ineffective drugs were chloroquine, proguanil, pyrimethamine, and sulfadoxine-pyrimethamine.

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