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Huge rise in malaria cases in the UK

Rise caused by people visiting relatives in malarial regions

OnMedica Staff

Friday, 04 July 2008

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Malaria is on the increase in the UK, according to a new study.

The findings, published today on BMJ.com, reveals that whereas there were 5,120 reported cases of potentially fatal faliciparum malaria in 1987-91, that has increased to 6,753 in 2002-6.

The authors attribute the rise to the increase in UK residents travelling to malaria endemic areas, combined with a failure to use prevention measures. In 1987 some 593,000 visits were made by UK residents to malarial areas, but by 2004 this had increased to 2.6 million visits.

These findings highlight the urgent need for health messages and services targeted at travellers from migrant groups visiting friends and family abroad, say the authors.

Dr Adrian Smith and colleagues from the Health Protection Agency’s Malaria Reference Laboratory, present the latest trends in malaria in the UK using data from the Malaria Reference Laboratory, involving 39,300 confirmed cases of malaria.

Imported malaria cases were heavily concentrated in communities with frequent travel to see friends and relatives in West Africa. Of all malaria imported to the UK, 96% of falciparum malaria occurred after travel to Africa. Travellers to Nigeria and Ghana, neither common tourist destinations, account for half of all imported falciparum cases.

Importantly, say the authors, only 42% of UK travellers reported taking any form of malaria prophylaxis during their travels. In particular, people visiting friends and relatives in their country of origin were less likely to report using prevention measures than other travellers. For example, amongst malaria cases in travellers to sub-Saharan Africa between 1999–2006, only 7% of people with malaria visiting friends and relatives reported using recommended drugs, compared to 24% of other travellers with malaria.

These findings highlight that health messages are not getting through to ethnic minority groups, particularly those visiting West Africa, warn the authors.

“Targeting messages tailored to these groups is essential in primary care and public health…and this would have a substantial impact on UK malaria,” they said.

Increasing the use of effective antimalarial prophylactic drugs by travellers visiting sub-Saharan Africa should be a priority, they conclude.

Research into cultural beliefs, knowledge and attitude towards malaria prevention in people visiting friends and relatives in malaria endemic countries, would help identify how best to target health education campaigns says Jane Zuckerman, Director of WHO collaborating centre for reference, research and training in travel medicine, in an accompanying editorial.

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