Malaria Prophylaxis in African and Asiatic Children Traveling to Their Parents' Home Country: A Florentine Study

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Abstract
The majority of malaria cases in Europe occur in immigrated adults and children settled in nonendemic countries but who had traveled to their home country to visit friends and relatives. We carried out a study on a sample of 71 parents immigrated from high-risk countries to investigate awareness of malaria risk and use of pharmacological and nonpharmacological (repellents, insecticides, nets, and insecticide-treated nets) prophylaxis. A questionnaire was administered to a convenience sample of immigrant parents who presented their children for acute care to the Emergency Department, Anna Meyer Children's University Hospital, Florence, Italy between August and November 2009. Fifty-nine out of 71 (83.1%) parents were aware of malaria risk in their native country. Forty-one (57.7%) children had traveled to their parents' home country. Nonpharmacological prophylaxis was used in 30 (73.1%) children. Eight (19.5%) children had received pharmacological prophylaxis, the mostly used drug being mefloquine in six out of eight (75%) patients. Seven out of eight (87.5%) children completed prophylaxis appropriately. Adverse drug reaction was reported in one (12.5%) patient. While abroad, eight (19.5%) parents and one (2.4%) child reported to have developed malaria. A significantly higher proportion of children traveling to Africa compared to children traveling to Asia (5/11 = 46% vs 3/30 = 10%, p = 0.036) had received pharmacological prophylaxis. Our data highlight the need for educational actions in Italy about malaria prophylaxis among immigrants. Larger epidemiological investigations are needed at this regard.