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Severe malaria in Canada, 2001-2013.

McCarthy AE, Morgan C, Prematunge C, Geduld J - Malar. J. (2015)

Bottom Line: Overall use and appropriateness of pre-travel advice and chemoprophylaxis remains low.Most cases result from patient delays in recognizing symptoms and seeking appropriate medical attention.Improved understanding of this population can help target risk reduction strategies and interventions to limit personal susceptibility and healthcare treatment delays.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. amccarthy@ottawahospital.on.ca.

ABSTRACT

Background: Imported malaria is the principal, preventable, life-threatening infection among Canadians travelling abroad. The Canadian Malaria Network supplies information and parenteral malaria therapy to healthcare providers treating severe and complicated malaria and gathers surveillance information on these cases.

Methods: Data were collected on the characteristics, risk factors, and clinical outcomes of severe malaria cases in Canada from June 2001 to December 2013.

Results: The need for parenteral therapy in Canada has increased in the last decade. The vast majority of cases are reported from Ontario and Quebec and occur among travellers to and from Africa. Regardless of country of birth, all persons originating from endemic and non-endemic countries are at a similar risk of malaria-related complications. Overall use and appropriateness of pre-travel advice and chemoprophylaxis remains low. Most cases result from patient delays in recognizing symptoms and seeking appropriate medical attention. Although some healthcare delays occurred in a select number of cases, the majority of patients were diagnosed quickly and were appropriately treated with parenteral therapy within a few hours of diagnosis.

Conclusions: Data from the Canadian Malaria Network provide insight into the characteristics of imported severe and complicated malaria infections in Canada. Improved understanding of this population can help target risk reduction strategies and interventions to limit personal susceptibility and healthcare treatment delays.

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Related in: MedlinePlus

Severe malaria cases in Canada per year by type of IV parenteral therapy requested.
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Fig3: Severe malaria cases in Canada per year by type of IV parenteral therapy requested.

Mentions: Among severe malaria cases, 116 (47%) were treated with IV quinine and 129 (52%) were treated with IV artesunate; both drugs were requested for three cases for which each was initially started on IV quinine, and were changed to IV artesunate therapy (1.0%). In one case treatment was switched to artesunate due to increased QTc with IV quinine, in two other cases quinine was given, since it was in stock, while awaiting transfer of artesunate from another hospital. Since the introduction of IV artesunate to Canada in 2009, the proportion of severe malaria cases treated with IV artesunate has increased rapidly as the treatment of choice (FigureĀ 3).Figure 3


Severe malaria in Canada, 2001-2013.

McCarthy AE, Morgan C, Prematunge C, Geduld J - Malar. J. (2015)

Severe malaria cases in Canada per year by type of IV parenteral therapy requested.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4418046&req=5

Fig3: Severe malaria cases in Canada per year by type of IV parenteral therapy requested.
Mentions: Among severe malaria cases, 116 (47%) were treated with IV quinine and 129 (52%) were treated with IV artesunate; both drugs were requested for three cases for which each was initially started on IV quinine, and were changed to IV artesunate therapy (1.0%). In one case treatment was switched to artesunate due to increased QTc with IV quinine, in two other cases quinine was given, since it was in stock, while awaiting transfer of artesunate from another hospital. Since the introduction of IV artesunate to Canada in 2009, the proportion of severe malaria cases treated with IV artesunate has increased rapidly as the treatment of choice (FigureĀ 3).Figure 3

Bottom Line: Overall use and appropriateness of pre-travel advice and chemoprophylaxis remains low.Most cases result from patient delays in recognizing symptoms and seeking appropriate medical attention.Improved understanding of this population can help target risk reduction strategies and interventions to limit personal susceptibility and healthcare treatment delays.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. amccarthy@ottawahospital.on.ca.

ABSTRACT

Background: Imported malaria is the principal, preventable, life-threatening infection among Canadians travelling abroad. The Canadian Malaria Network supplies information and parenteral malaria therapy to healthcare providers treating severe and complicated malaria and gathers surveillance information on these cases.

Methods: Data were collected on the characteristics, risk factors, and clinical outcomes of severe malaria cases in Canada from June 2001 to December 2013.

Results: The need for parenteral therapy in Canada has increased in the last decade. The vast majority of cases are reported from Ontario and Quebec and occur among travellers to and from Africa. Regardless of country of birth, all persons originating from endemic and non-endemic countries are at a similar risk of malaria-related complications. Overall use and appropriateness of pre-travel advice and chemoprophylaxis remains low. Most cases result from patient delays in recognizing symptoms and seeking appropriate medical attention. Although some healthcare delays occurred in a select number of cases, the majority of patients were diagnosed quickly and were appropriately treated with parenteral therapy within a few hours of diagnosis.

Conclusions: Data from the Canadian Malaria Network provide insight into the characteristics of imported severe and complicated malaria infections in Canada. Improved understanding of this population can help target risk reduction strategies and interventions to limit personal susceptibility and healthcare treatment delays.

Show MeSH
Related in: MedlinePlus