France has the highest number of imported malaria cases among European countries (approximately 6,500 to 7,000 per year over the past four years) compared to countries with similar populations: United Kingdom: 1,800 to 2,500; Germany: 900; Italy: 850; Spain, the Netherlands, Switzerland: approximately 300 cases each; the United States, meanwhile, reports approximately 1,500 cases annually. While malaria is a notifiable disease in nearly all non-endemic countries, malaria surveillance in metropolitan France relies on two National Reference Centers responsible respectively for epidemiology (CNREPIA) and for studying the drug sensitivity of Plasmodium strains (CNRCP), both of which operate through networks of volunteer correspondents. These two centers will be merged into a single entity in 2006. An estimate of the total annual number of cases is derived from reporting data, the representativeness of which is regularly assessed through comprehensive surveys conducted in partnership with the national quality control program in parasitology (French Health Products Safety Agency, latest survey in 2004) and/or analysis of PMSI data (Institute for Public Health Surveillance). (Excerpt)