Seringe E, Thellier M, Fontanet A, Legros F, Bouchaud O, Ancelle T, Kendjo E, Houze S, Le Bras J, Danis M.
Emerg Infect Dis 2011;17:807-13.

Using surveillance data obtained from 21,888 imported Plasmodium falciparum cases in France during 1996-2003, factors independently associated with severe malaria (832 cases; ≈3.8%) were older age, European origin, travel to eastern Africa, absence of chemoprophylaxis, initial visit to a general practitioner, time to diagnosis of 4 to 12 days, and diagnosis during the fall-winter season. The global case-fatality rate was 0.4%.

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ECDC comment: Infection with Plasmodium falciparum malaria remains a major risk for European travellers returning from malaria-endemic areas. This study confirms the relevance of severity factors identified in non-immune travellers and elderly persons. It emphasizes the lack of awareness of the practitioners and public concerning malaria strengthening the importance of anti malarial chemoprophylaxis.