As we know from previous published articles, malaria is transmitted by the Anopheles mosquito: there are about 400 different species of Anopheles mosquitoes, but 30 of these can most easily transmit the pathogen that causes infection, Plasmodium.
The likelihood of transmission is related to several factors: the parasite, the vector, the human host, and the environment; for example, the long life cycle of Anopheles mosquitoes and the great possibility of biting humans makes Africa the country with 90% of the world's malaria cases,which is also why it is important to carry out a pre-travel counseling when traveling to Africa. Transmission also depends on weather conditions (especially rainfall, temperature, and humidity).
Host immunity is also an important factor: adults in endemic areas, given prolonged contact, develop immunity that becomes protective. Conversely, children in the same tropical areas are the most affected and those at greatest risk of death. (1)
In this context is the interesting Italian contribution (2) regarding the increased risk of malaria in travelers over 60. The article takes its cue from the fact that about 30% of European travelers are over 60 years of age and that this population segment is, statistically, more at risk of disease and in particular more at risk of contracting even fatal forms of malaria.
The p>The over 60 population is at greater risk of malaria.
The prevention of malaria is based on the acronym ABCD, from the English:
- A - Awarness of the risks; .
- B - Bite prevention measures (mosquito bite prevention);
- C - Chemoprofylaxis (pharmacological prophylaxis);
- D - Diagnosis (diagnosis).
The study showed that older travelers tend not to use mosquito bite prevention measures: mosquito sprays, clothes covering all areas of the body, mosquito nets at night.
The reason why this happens seems to be a lack of information regarding the importance of these simple measures, which, moreover, are also essential in protecting oneself from other diseases such as yellow fever and dengue, both of which are carried by mosquito bites.
In addition, older travelers are less accurate in taking prophylactic therapy, likely related to comorbidities and polypharmacy already taken, but also due to side effects. This finding leads to the need to draft protocols that are more "tailored" to this segment of the population.
In conclusion, it is essential to provide more widespread information to older travelers, which takes into account their previous experiences (and thus the possibility that they may already feel travel savvy) as well as the frailty inherent in age.
For this reason, Ambimed always recommends pre-travel counseling prior to within 20 days of the planned trip.
Sources:
- WHO
- Del Prete V. et al, J Trav Med 2019, 1-8
