Target malaria advice to elderly, tourists
GPs should target the elderly and holidaymakers for pre-travel malaria prevention advice, say public health experts.
Their research showed that most UK deaths from malaria over the period 1987-2006 occurred in people over 65, and tourists.
While travellers visiting friends and family in countries with endemic malaria made up the majority of malaria cases, their risk of dying from the infection was smaller than for other travellers, the team explains.
Professor Christopher Whitty (London School of Hygiene and Tropical Medicine) and colleagues found that there were a total of 191 malaria-associated deaths out of a total of 39,302 cases of confirmed malaria over the study period. The large majority of these were related to P falciparum infection.
Case fatality was highest among those aged over 65 years, who were 10 times as likely to die from infection as those aged 18-35 years, while mortality among infants and children was relatively low, with no deaths among those aged 5 or under.
There was also a strong association between case fatality and the purpose of the visit, with tourists having eight times the risk of dying compared with people visiting friends and relatives. Of note, travellers to the Gambia - a popular destination for 'winter sun' - were at particularly high risk, while deaths were also higher among patients presenting in the month of December and those presenting in UK regions where malaria is seldom seen.
The authors conclude that "the older traveller, travellers born in countries not endemic for malaria, and those travelling on 'winter sun' holidays" may be most likely to benefit from pre-travel advice. This includes encouraging patients not only to take antimalaria and chemoprevention measures, but also to visit a doctor promptly if they develop a fever.
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Caroline Price