Travellers To Nigeria And Ghana Continue To Bear Burden Of Malaria

Main Category: Tropical Diseases
Also Included In: Infectious Diseases / Bacteria / Viruses;  Public Health
Article Date: 24 Apr 2009 - 3:00 PDT

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New figures from the Health Protection Agency show that UK travellers visiting friends and family abroad, particularly in Nigeria and Ghana, continue to be the group of people most likely to acquire malaria.

In 2008 there were 1,370 cases of malaria reported in the UK. For those cases where the region of travel was known, 71 per cent were in those who had visited West Africa. The countries with the highest number of cases were Nigeria (492) and Ghana (148).

Whilst there has been a fall of 178 in total cases compared to 2007 when there were 1,548 cases, the total from Nigeria was unchanged at 492 for both years and there was a modest fall in cases from Ghana (185 in 2007).

Among those who were travellers from the UK (rather than normally resident in an endemic area) where reason for travel was known, 552/716 (77 per cent) were Visiting Friends and Relatives in their country of origin (VFR travellers).

Previous research has shown that VFR travellers are less likely to report using preventative measures for malaria than other travellers and that they are more likely to acquire malaria compared to other groups.

VFR travellers are also at greater risk of other travel-related infectious diseases, compared to business or holiday travellers, because they tend to travel for longer periods of time (e.g. a month or more) and usually stay at the family or friend's home. They effectively become members of the local population while they are there and are consequently exposed to similar infection risks.

The overwhelming majority (79 per cent) of all cases of malaria that were diagnosed in the UK were due to Plasmodium falciparum.

Professor Peter Chiodini, who heads up the Agency's Malaria Reference Laboratory, said: "Although it is good news that for the second year running we have seen a fall in the number of people that are contracting malaria, too many people are still falling unwell from this preventable disease by not taking appropriate precautions before and during their travel.

"Over the last five years the burden of imported disease has consistently been seen in people who have visited West Africa - particularly Nigeria and Ghana. Given these facts, we urge everyone who is travelling to take the necessary precautions to protect themselves and their families. Furthermore, if they become unwell in the year after their trip they should seek medical attention without delay and mention malaria."

Dr Jane Jones, a travel health expert at the Health Protection Agency, said: "No one should underestimate how serious a disease malaria is. Treatment might involve a stay in hospital and everyone will have to take a course of tablets to kill the parasites in the blood. Children, the elderly and pregnant women are more likely to develop serious disease or to deteriorate rapidly."

"But malaria is preventable and there are a range of measures available for people to protect themselves. Anyone travelling to a malaria endemic area should seek appropriate advice from their GP or a specialist travel clinic before they travel and follow the advice given.

"It is a myth that people who have had malaria will not get it again. The advice is the same for all travellers - you must take anti-mosquito precautions and medication to keep safe".

Notes

The full report can be found here.

There are several different types of malaria and the data show that there has been a steady rise in the proportion of cases due to Plasmodium falciparum, which is the cause of most deaths from malaria. This type of malaria was most commonly seen in people who had been to West Africa, particularly Nigeria and Ghana. The majority of other cases of malaria were Plasmodium vivax and these are mainly seen in people who have been to South Asia.

Global impact of malaria

Malaria has a massive impact on human health; it is the world's second biggest killer after tuberculosis. Around 300 million clinical cases occur each year resulting in between 1.5 - 2.7 million deaths annually, the majority in sub-Saharan Africa. It is estimated that 3,000 children under the age of five years fall victim to malaria each day. Around 40% of the world's population is at risk. The societies and economic development of some of the world's poorest nations are severely affected by malaria.

Symptoms

It is important for travellers to be aware of the symptoms of malaria, which can include a flu-like illness, fever, shaking, headache, muscle aches and tiredness. Nausea, vomiting and diarrhoea may also occur.

If travellers develop these symptoms whilst abroad or up to one year after returning, they should seek prompt medical advice and tell their doctor they have been in an area where malaria is a hazard.

Seeking advice

Members of the public should seek advice about their specific travel health needs from their GP surgery or local travel clinic.

An information sheet on insect bite avoidance, updates on other travel health issues, and country specific health advice are available on the National Travel Health Network and Centre (NaTHNaC) website at http://www.nathnac.org

Specialist advice

The risks posed by malaria in some countries change over time. Health professionals who require assistance and more specialist advice when advising travellers should contact the HPA Malaria Reference Laboratory (020 7636 3924) or NaTHNaC (0845 602 6712).

Travel guidelines

The Health Protection Agency's Advisory Committee on Malaria Prevention for UK Travellers (ACMP) has produced guidelines for healthcare workers who advise travellers or prospective travellers who wish to read about the options themselves. Guidelines are available here.

Malaria Reference Laboratory

The Malaria Reference Laboratory provides an integrated service for public health in relation to malaria. It combines reference and diagnostic parasitology of malaria with surveillance of all imported malaria reported in the UK, analysing the results and using these, together with wide consultation to develop national policy on prevention of imported malaria, which it then disseminates widely.

Source
Health Protection Agency

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