The role of visiting friends and relatives (VFRS) in imported malaria

With the integration of immigrants in their host countries, a new, special group of travellers - Visiting Friends and Relatives (VFRs) - has emerged over time. The term VFRs refers in particular to immigrants who move to high-income countries from countries where socio-economic status is low, and regularly return to their country of origin, sometimes for fairly long periods of time, to visit their friends and relatives or, where women are concerned, also to give birth and spend the post-partum period with their family. Precisely because they are “special tourists”, VFRs are considered to be at higher risk than other regular travellers of contracting diseases like tuberculosis, HIV and malaria. In fact, because they still feel ethnically integrated in their country of origin, many of them do not take adequate preventive measures to reduce risks to their health.Although many studies have been conducted on this particular group of travellers, we still lack sufficient information, in our country especially, that enables us to undertake suitable prevention initiatives. Malaria is the most frequently contracted infection among VFRs, with a significant difference (p<0.001) compared to more recent immigrants and other categories of travellers. More than 75% of imported malaria cases occur in immigrants, and almost all of them are in the Visiting Friends and Relatives category. In more than 90% of cases the infection is caused by P. falciparum and regards individuals from sub-Saharan African countries. It is important to note that almost all the women and children with imported malaria belong to the VFRs category.