The Risk of Malaria in Travelers to India
The Risk of Malaria in Travelers to India
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DOI：
10.1111/j.1708-8305.2009.00332.x
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发表时间：
2009-05-01
影响因子：
25.7
通讯作者：
Schlagenhauf, Patricia
中科院分区：
文献类型：
--
作者：
Schmid, Sabine;Chiodini, Peter;Schlagenhauf, Patricia
一些国家报告称，从印度回国的旅行者输入性疟疾病例有所减少。我们收集了 1992 年至 2005 年期间来自 9 个国家的输入性疟疾数据。旅行者统计分母数据来自印度旅游部。疟疾病例数从1992年的每10万名旅行者93例下降到2005年的每10万名旅行者19例。恶性疟原虫的比例多年来稳步下降。前往印度的旅行者中，间日疟原虫占所有疟疾病例的 80% 以上。因疟疾死亡的情况很少见； 1992年至2005年间，只有英国和美国报告了死亡人数，总共16人。利用地方性疟疾数据可以清楚地确定印度的疟疾高风险地区。高风险州包括恰蒂斯加尔邦、奥里萨邦、贾坎德邦、西孟加拉邦、果阿邦（主要是间日疟）以及孟加拉国东部各邦。前往印度的旅行者中疟疾发病率的下降和间日疟的高比例支持了一些欧洲国家当前指南的变化，提倡使用备用紧急自我治疗策略或咬伤预防措施加上风险意识，而不是化学预防。否则，在高风险国家，仍应考虑化学预防，特别是在高传播季节。
Several countries have reported a decline in malaria cases imported by travelers returning from India.We collected data on imported malaria for the period 1992 to 2005 from nine countries. Traveler statistics denominator data were obtained from the Indian Ministry of Tourism.The malaria case numbers declined from 93 cases per 100,000 travelers in 1992 to 19 cases per 100,000 travelers in 2005. The proportion of Plasmodium falciparum decreased steadily throughout the years. The proportion of Plasmodium vivax accounts for more than 80% of all cases of malaria in travelers to India. Deaths due to malaria were rare; only the UK and the United States reported deaths, a total of 16, between 1992 and 2005. The high-risk areas for malaria in India can be clearly identified using endemic malaria data. High-risk states are Chhattisgarh, Orissa, Jharkhand, West Bengal, Goa (mainly P vivax), and the states east of Bangladesh.The decreasing incidence of malaria in travelers to India and the high proportion of P vivax support the current change in guidelines in some European countries advocating the use of the standby emergency self-treatment strategy or bite precautions plus awareness of risk instead of chemoprophylaxis. Otherwise in high-risk states, chemoprophylaxis should still be considered particularly in high-transmission seasons.