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. 2007 Aug 23:6:114.
doi: 10.1186/1475-2875-6-114.

The low and declining risk of malaria in travellers to Latin America: is there still an indication for chemoprophylaxis?

Ron H Behrens  1 , Bernadette Carroll, Jiri Beran, Olivier Bouchaud, Urban Hellgren, Christoph Hatz, Tomas Jelinek, Fabrice Legros, Nikolai Mühlberger, Bjørn Myrvang, Heli Siikamäki, Leo Visser; TropNetEurop
Affiliations

The low and declining risk of malaria in travellers to Latin America: is there still an indication for chemoprophylaxis?

Ron H Behrens et al. Malar J. .

Abstract

A comparison was made between local malaria transmission and malaria imported by travellers to identify the utility of national and regional annual parasite index (API) in predicting malaria risk and its value in generating recommendations on malaria prophylaxis for travellers. Regional malaria transmission data was correlated with malaria acquired in Latin America and imported into the USA and nine European countries. Between 2000 and 2004, most countries reported declining malaria transmission. Highest API's in 2003/4 were in Surinam (287.4) Guyana (209.2) and French Guiana (147.4). The major source of travel associated malaria was Honduras, French Guiana, Guatemala, Mexico and Ecuador. During 2004 there were 6.3 million visits from the ten study countries and in 2005, 209 cases of malaria of which 22 (11%) were Plasmodium falciparum. The risk of adverse events are high and the benefit of avoided benign vivax malaria is very low under current policy, which may be causing more harm than benefit.

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Figures

Figure 1
Figure 1
Total visits made by international tourists to the study countries adjusted to visits from the reporting countries.
Figure 2
Figure 2
Imported cases by reporting countries 2000–2005. Y axis 1 reflects US and French cases, all other countries are shown against Y axis 2.
Figure 3
Figure 3
Total imported malaria from 9 countries stratified by US and Non US reporting countries 2000–2005.
See this image and copyright information in PMC

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