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Malaria 'significantly increasing in UK'

04/07/2008

Cases of malaria in the UK have significantly increased over the past 20 years, according to a new study published today.

Researchers at the Health Protection Agency argue that the increase is a result of a huge rise in the numbers of UK residents travelling to areas where malaria is endemic as well as a failure to use prevention measures.

Between 1987 and 1991 there were 5,120 reported cases of the potentially fatal faliciparum malaria.

This rose to 6,753 between 2002 and 2006.

The figures were revealed using data from the Malaria Reference Laboratory, involving 39,300 confirmed cases of malaria.

Nearly two-thirds (64.5 per cent) of 20,488 malaria cases amongst UK travellers had visited friends and relatives in malaria endemic countries.

This is reflected by the huge increase in the number of UK residents travelling to malaria endemic areas - from 593,000 visits in 1987 to 2.6 million visits in 2004.

Imported malaria cases were heavily concentrated in communities with frequent travel to see friends and relatives in West Africa.

The researchers also discovered a worrying trend in cases of the potentially fatal falciparum malaria, which have increased steady over the past 20 years in the UK.

Of all malaria imported to the UK, 96 per cent of falciparum malaria occurred after travel to Africa.

Travellers to Nigeria and Ghana account for half of all imported falciparum cases.

Writing in the British Medical Journal (BMJ), the researchers say that public health messages must be improved as just 42 per cent of travellers reported taking any form of malaria treatment 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.

Amongst malaria cases in travellers to sub-Saharan Africa between 1999 and 2006, only seven per cent of people with malaria visiting friends and relatives reported using recommended drugs, compared to 24 per cent of other travellers with malaria.

"This study highlights the need for general practitioners and people involved in public health to focus tailored messages on preventing malaria on members and descendants of migrant families visiting friends and relatives, especially in African migrant families," the researchers conclude.

"The UK has guidelines based on consensus that highlight the need for all UK residents, irrespective of country of birth, to use effective anti-malarial prophylaxis when visiting highly endemic areas.

"Changes to public health policy, including the current policy of charging for anti-malarial prophylaxis, may need to be considered. Malaria is an almost entirely preventable, potentially fatal, disease that poses a considerable risk to some migrant groups."