Imported malaria in children in France

Among the European countries, France is the most affected by imported malaria. The aim of this study was to take stock of the situation of imported malaria in children in France. Methods. - Attacks of malaria in children less than 15-year-old which have been notified to Centre National de Reference des Maladies d'Importation (CNRMI) were reviewed retrospectively between 1995 and 1997 and 1995 and 1998 for severe malaria. Results. - Over a period of 3 years, 1256 malaria attacks were notified in children including 90.9% without signs of severity. The mean age was 7 years. Sex ratio was 1.19. About 44.5% were French. Most of the cases were acquired in Africa. Plasmodium falciparum was involved in 79.2% of the cases. About 61.8% of children have been under prophylaxis but only 37.9% admit good compliance. Chemoprophylaxis was frequently inadequate. Halofantrine was prescribed for 76% of these children. Over a 4-year period, 51 children were notified as severe malaria attacks. Among them, 17 had severe malaria as defined by the World Health Organisation criteria. Most of these patients (73%) were treated by quinine by intravenous route. Two children died. Conclusion. - Paediatric malaria is not rare in France. Only the improvement of prophylaxis could decrease the incidence of malaria in France. (C) 2003 Editions scientifiques et medicales Elsevier SAS. Tous droits reserves.