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Malaria in Gambia and Burundi
Updated: January 15, 2001
Health Canada continuously monitors reports of malaria activity around the
world. Malaria is constantly present (i.e., endemic) in most of sub-Saharan
Africa; in many areas of the Middle East, South Asia, Southeast Asia, Oceania,
Haiti, Central and South America; and in certain parts of Mexico, North Africa
and the Dominican Republic.
At this time, Health Canada is receiving reports of increased levels of
malaria activity in two countries in Africa.
Gambia
The European Network on Imported Infectious Disease Surveillance, TropNetEurop,
is recording an increase in numbers of patients returning with falciparum
malaria from West Africa, especially from Gambia. The number of cases of severe,
and sometimes fatal, malaria in European nationals visiting Gambia is cause
for concern. The early winter holiday period overlaps with the high transmission
season for falciparum malaria there, and most of the travellers who become
ill take either no or inadequate preventive treatment (i.e., chemoprophylaxis).
In recent weeks, the Hospital for Tropical Diseases in London and other specialist
centres have admitted over 30 patients severely ill with malaria contracted
in Gambia, several of whom have required intensive care. Cases have also been
reported in Sweden, Spain, Germany, Austria and Denmark.
Sources: Eurosurveillance Weekly, Issue 50, December 20, 2000; Infectious Disease News Brief, January 5, 2001, Health Canada
Burundi
The World Health Organization reports that a malaria epidemic has affected
an estimated 276,000 people in the northern highland districts of Burundi.
As of the end of November 2000, 115 deaths had been officially reported. Data
from clinics in the Kayanza province collected in mid-November show 21,000
cases of malaria among the population of 200,400, an increase of more than
500% compared to the same period in 1999. Laboratory tests have shown that
80% of suspected cases from the Kayanza province are positive for falciparum
malaria. The situation is complicated by the fact that the cheapest available
drug, chloroquine, cannot continue to be used because of high levels of resistance
to the drug in the area.
Source: Weekly Epidemiological Report (no. 1, Jan. 5, 2001) World
Health Organization
Recommendation
Health Canada strongly recommends that Canadians travelling to countries
where malaria occurs, including Gambia and Burundi, contact a physician or
travel medicine clinic prior to departure for an individual risk assessment.
Based on the traveller's anticipated travel itinerary and health history,
the risk of malaria exposure can be determined as well as the appropriate
antimalarial prophylactic medication can be prescribed and information on
mosquito prevention measures can be provided, if warranted.
For more information, visit our disease
information page on malaria at:http://www.phac-aspc.gc.ca/tmp-pmv/info/pal_mal_e.html.
For a guidelines on malaria from the Committee to Advise on Tropical
Medicine and Travel (CATMAT), visit the "Canadian
recommendations for the prevention and treatment of malaria among international
travellers" at http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/00vol26/26s2/index.html.
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