Volume 17, Number 5—May 2011
CME ACTIVITY - Research
Severe Imported Plasmodium falciparum Malaria, France, 1996–2003
Table 5
Factors independently associated with severe malaria among patients treated for Plasmodium falciparum malaria in hospitals, France, 1996–2003*
Variables | Odds ratio (95% confidence interval) | p value |
---|---|---|
Age group, y | ||
<15 | 1 | <0.0001 |
16–30 | 0.9 (0.7–1.2) | |
31–45 | 1.06 (0.8–1.3) | |
46–60 | 1.8 (1.4–2.3) | |
>60 |
2.7 (2.0–3.6) |
|
Origin and residence | ||
African travelers | 1 | <0.0001 |
African residents | 1.5 (1.1–1.9) | |
European travelers | 3.2 (2.6–3.8) | |
European expatriates | 3.7 (2.9–4.9) | |
Others |
1.9 (1.5–2.6) |
|
Region of malaria acquisition | ||
Western Africa | 1 | <0.0001 |
Central Africa | 0.8 (0.7–0.9) | |
Eastern Africa | 2.6 (1.7–4.1) | |
Austral Africa | 1.1 (0.6–2.2) | |
Madagascar and Comoros Islands | 0.7 (0.5–0.9) | |
Others |
0.9 (0.6–1.5) |
|
Chemoprophylaxis | ||
Appropriate drugs† | 1 | 0.001 |
No chemoprophylaxis | 1.3 (1.1–1.5) | |
Inappropriate drugs‡ |
1.5 (1.2–1.9) |
|
Place of first visit | ||
Hospital | 1 | |
General practitioner |
1.4 (1.2–1.7) |
<0.0001 |
Time between onset and diagnosis, d | ||
<1 | 1 | <0.0001 |
2–3 | 0.9 (0.8–1.2) | |
4–6 | 1.6 (1.3–1.9) | |
7–12 | 1.5 (1.1–1.8) | |
>12 |
0.7 (0.5–0.9) |
|
Symptom onset | ||
After return to France | 1 | |
Before return to France |
1.2 (1.01–1.5) |
0.03 |
Season of diagnosis | ||
Spring–summer | 1 | |
Fall–winter | 1.3 (1.2–1.5) | <0.0001 |
*N = 21,888.
†Appropriate chemoprophylactic drugs were mefloquine, atovaquone-proguanil, doxycycline, and chloroquine-proguanil.
‡According to national recommendations, inappropriate chemoprophylactic drugs were chloroquine, proguanil, pyrimethamine, and sulfadoxine-pyrimethamine.
1Additional members of the French National Reference Center for Imported Malaria Study Group who contributed data are listed in the Technical Appendix.