%0 Journal Article
%T Declining incidence of malaria imported into the UK from West Africa
%A Ron H Behrens
%A Bernadette Carroll
%A Valerie Smith
%A Neal Alexander
%J Malaria Journal
%D 2008
%I BioMed Central
%R 10.1186/1475-2875-7-235
%X Using passenger numbers and malaria surveillance reports, the data revealed a 2.3-fold increase in travel to West Africa with a five-fold increase in travelers visiting friends and relatives (VFR). Malaria incidence fell through the study period, the greatest decline noted in VFR with a fall from 196 cases/1,000 person-years to 52 cases/1,000 person-years, 9.8% per year p < 0.0001. The risk for travellers from the UK visiting for other reasons declined 2.7 fold, at an annual decrease of 7.0%, with the incidence in West African visitors to the UK falling by 2.3 fold, a rate of 7.9% annually.The reduction in incidence among all three groups of travellers may be explained by several factors; changing chemoprophylaxis usage and/or increased travel in urban areas where malaria risk has declined over the past decade, or widespread reduction in malaria transmission in West Africa.With the reduction in malaria incidence seen in both visitors to and from West Africa, the most rational explanation for these findings is a fall in malaria transmission in West Africa, which may require a change in chemoprophylaxis policy for UK travelers over the next 5¨C10 years.Malaria remains a threat to travellers visiting endemic regions. Since 1987, approximately 39,000 cases of malaria have been reported to the UK reference laboratory [1]. A number of risk factors for acquiring malaria during travel have been identified, of which destination is the most important. West Africa accounts for approximately two thirds of all cases reported in the UK, with travellers to Nigeria and Ghana making up half of all imported Plasmodium falciparum infections [2,1]. The reason for travel is another significant contributory factor and three quarters of all reported cases occur in travellers who have been visiting friends and relatives (VFR)[3,1,4] in West Africa. Failure to take or comply with the correct chemoprophylactic regimens is associated with higher rates of malaria. Unsurprisingly, only 42% of ma
%U http://www.malariajournal.com/content/7/1/235