Management of uncomplicated
5 affiliations
- 1Centre Hospitalier Universitaire de Bichat, Service des Urgences, Paris, France; Corresponding author.
- 2Centre National de Référence du paludisme, Hôpital Bichat, Paris, France
- 3Unité parasitologie et entomologie, Département risques infectieux, Institut de recherche biomédicale des armées, Marseille, France; Institut Hospitalo-universitaire Méditerranée Infection, Marseille, France; Centre National de référence du paludisme, Marseille, France
- 4Centre Hospitalier Universitaire de Lariboisière, Service des Urgences, Paris, France
- 5Centre Hospitalier Universitaire de Pitié-Salpêtrière, Paris, France
Abstract
Background: Uncomplicated Plasmodium falciparum malaria is a common imported infection in non-endemic countries. We evaluated management, early follow-up, and factors associated with hospitalization at initial presentation among patients treated with artemisinin-based combination therapies (ACTs) in France. Methods: We conducted a national retrospective study including adults diagnosed with uncomplicated Plasmodium falciparum malaria without vomiting, treated with ACTs, and reported to the French National Reference Center for Malaria between 2021 and 2024. The primary endpoint was factors associated with hospitalization at initial presentation (versus outpatient management), assessed using multivariable and mixed-effects logistic regression. Early clinical, biological, and parasitological follow-up (days 1–7) was analyzed descriptively. Results: Among 3248 patients treated with ACTs, 1210/3087 (39.2%) were hospitalized at the time of initial presentation. Fever, immunosuppression, platelet count <84 G/L, parasitemia ≥0.16%, and hemoglobin <12.4 g/dL were independently associated with hospitalization, whereas diagnosis in 2024 was associated with a lower risk. Among the 1098 (33.8%) patients with available follow-up data, adverse events occurred in <2%. Among patients whose first documented parasitological assessment occurred during days 1–3, the parasite positivity rate was 11/460 (2.4%); no positive parasitemia was observed among those whose first documented assessment occurred during days 4–7 (0/215). In the mixed-effects model, age ≥50 years was also associated with hospitalization. Conclusion: In this large national cohort, an evolving trend toward more frequent outpatient management in real-world practice was observed. The lack of documented early follow-up data in both inpatients and outpatients highlights the need to improve follow-up monitoring and reporting.
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BibTeX
@article{minka2026management,
title = {{Management of uncomplicated}},
author = {Sally Oceane Minka and Roger Wumba and Souad Bani and Bruno Pradines and Marylin Madamet and Océane Delandre and Emilie Javelle and Fadi Hillary Minka and Marc Thellier and Sandrine Houze},
journal = {Travel Medicine and Infectious Disease},
year = {2026},
month = oct,
doi = {10.1016/j.tmaid.2026.103031},
url = {https://doi.org/10.1016/j.tmaid.2026.103031},
note = {CC BY},
}
RIS
TY - JOUR
TI - Management of uncomplicated
AU - Sally Oceane Minka
AU - Roger Wumba
AU - Souad Bani
AU - Bruno Pradines
AU - Marylin Madamet
AU - Océane Delandre
AU - Emilie Javelle
AU - Fadi Hillary Minka
AU - Marc Thellier
AU - Sandrine Houze
PY - 2026
DA - 2026/10/30
JO - Travel Medicine and Infectious Disease
DO - 10.1016/j.tmaid.2026.103031
UR - https://doi.org/10.1016/j.tmaid.2026.103031
AB - Background: Uncomplicated Plasmodium falciparum malaria is a common imported infection in non-endemic countries. We evaluated management, early follow-up, and factors associated with hospitalization at initial presentation among patients treated with artemisinin-based combination therapies (ACTs) in France. Methods: We conducted a national retrospective study including adults diagnosed with uncomplicated Plasmodium falciparum malaria without vomiting, treated with ACTs, and reported to the French National Reference Center for Malaria between 2021 and 2024. The primary endpoint was factors associated with hospitalization at initial presentation (versus outpatient management), assessed using multivariable and mixed-effects logistic regression. Early clinical, biological, and parasitological follow-up (days 1–7) was analyzed descriptively. Results: Among 3248 patients treated with ACTs, 1210/3087 (39.2%) were hospitalized at the time of initial presentation. Fever, immunosuppression, platelet count <84 G/L, parasitemia ≥0.16%, and hemoglobin <12.4 g/dL were independently associated with hospitalization, whereas diagnosis in 2024 was associated with a lower risk. Among the 1098 (33.8%) patients with available follow-up data, adverse events occurred in <2%. Among patients whose first documented parasitological assessment occurred during days 1–3, the parasite positivity rate was 11/460 (2.4%); no positive parasitemia was observed among those whose first documented assessment occurred during days 4–7 (0/215). In the mixed-effects model, age ≥50 years was also associated with hospitalization. Conclusion: In this large national cohort, an evolving trend toward more frequent outpatient management in real-world practice was observed. The lack of documented early follow-up data in both inpatients and outpatients highlights the need to improve follow-up monitoring and reporting.
SN - 1873-0442
ER -