{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:25:22Z","timestamp":1790601922284,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delayed treatment is associated with a higher risk of severe malaria. In malaria-endemic areas, the main factors associated with delay in seeking healthcare are low educational level and traditional beliefs. In imported malaria, determinants of delay in seeking healthcare are currently unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied all patients presenting with malaria, from 1 January 2017 to 14 February 2022, in the hospital of Melun, France. Demographic and medical data were recorded for all patients, and socio-professional data were recorded for a subgroup of hospitalized adults. Relative-risks and 95% confidence intervals were determined using univariate analysis by cross-tabulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 234 patients included, all travelling from Africa. Among them, 218 (93%) were infected with P. falciparum, 77 (33%) had severe malaria, 26 (11%) were &amp;lt;18\u00a0years old and 81 were included during the SARS-CoV-2 pandemic. There were 135 hospitalized adults (58% of all patients). The median time to hospital admission (THA) , defined by the period from onset of symptoms to arrival at hospital, was 3\u00a0days (IQR = 2\u20135). A THA \u22653\u00a0days tended to be more frequent in travellers visiting friends and relatives (VFR; RR = 1.44, 95% CI = [1.0\u20132.05], P\u2009=\u20090.06), while it was less frequent in children and teenagers (RR = 0.58, 95% CI = [0.39\u20130.84], P\u2009=\u20090.01). Gender, African background, unemployment, living alone and absence of referring physician were not associated with delay in seeking healthcare. Consulting during the SARS-CoV-2 pandemic was neither associated with a longer THA nor with a higher rate of severe malaria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In contrast to an endemic area, socio-economic factors did not impact on delay in seeking healthcare in imported malaria. Prevention should focus on VFR subjects, who tend to consult later than other travellers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taad023","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T17:18:07Z","timestamp":1676567887000},"source":"Crossref","is-referenced-by-count":15,"title":["Factors associated with delay in seeking healthcare for imported malaria: a retrospective study in a French hospital"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7840-2104","authenticated-orcid":false,"given":"Clara","family":"Flateau","sequence":"first","affiliation":[{"name":"Service des maladies infectieuses, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Picque","sequence":"additional","affiliation":[{"name":"Laboratoire de biologie m\u00e9dicale, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Cornaglia","sequence":"additional","affiliation":[{"name":"Service d\u2019accueil des urgences, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lia","family":"Pitsch","sequence":"additional","affiliation":[{"name":"Laboratoire de biologie m\u00e9dicale, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracie","family":"Youbong","sequence":"additional","affiliation":[{"name":"Service des maladies infectieuses, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Leroy","sequence":"additional","affiliation":[{"name":"Service des maladies infectieuses, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"de Pontfarcy","sequence":"additional","affiliation":[{"name":"Service des maladies infectieuses, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Jault","sequence":"additional","affiliation":[{"name":"Service de gyn\u00e9cologie-obst\u00e9trique, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Thach","sequence":"additional","affiliation":[{"name":"Service de p\u00e9diatrie, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryse","family":"Camus","sequence":"additional","affiliation":[{"name":"Pharmacie hospitali\u00e8re, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Dolveck","sequence":"additional","affiliation":[{"name":"Service d\u2019accueil des urgences, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Diamantis","sequence":"additional","affiliation":[{"name":"Service des maladies infectieuses, Groupe hospitalier Sud Ile de France , Melun 77000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"2023051915582895200_ref1","doi-asserted-by":"crossref","first-page":"taaa207","DOI":"10.1093\/jtm\/taaa207","article-title":"Aetiology of fever in returning travellers and migrants: a systematic review and meta-analysis","volume":"27","author":"Buss","year":"2020","journal-title":"J Travel Med"},{"key":"2023051915582895200_ref2","volume-title":"Malaria; 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