Imported malaria in children: incidence and risk factors for severity

To assess the incidence of imported malaria in children and to determine the frequency of delayed diagnosis and risk factors for severe malaria, we performed a retrospective multicenter cohort study in the northern region of France and included all children with a positive test for malaria from 2000 to 2006. The incidence of imported malaria in children <18 years, the frequency of a delayed diagnosis, and the risk factors for severe malaria were determined. The study identified 133 children with imported malaria. The mean incidence of this disease was 1.9/100 000 children <18 years (95% confidence interval [CI], 1.6–2.2). Detailed data were available for 120 children. Disease was considered severe in 19% of cases. The diagnosis was delayed (≥1 day after the first medical contact) in 31% of cases, and this delay was the only independent risk factor identified for severe imported malaria in children (adjusted odds ratio, 3.2; 95% CI, 1.2–8.8; P = 0.02).