Increase of malaria in the Dominican Republic

In November 1999 nine European cases of malaria caused by Plasmodium falciparum reportedly were imported by tourists from the Dominican Republic. The incidence of malaria has increased since the hurricane George and since building activities for tourist centres have favoured growth of the mosquito population. Travellers to the Dominican Republic are advised to take precautions against mosquitoes and to take proguanil prophylaxis also malaria should be considered in patients with fever who have visited the area, if only as tourists.     

Imported malaria at the Marseilles Hôpital-Nord, France: a prospective study on 352 cases between 2001 and 2003

OBJECTIVE: The authors had for aim to study epidemiological, clinical, and parasitological characteristics, as well as regimen received, of imported malaria cases hospitalised at the North University Hospital, in Marseilles, France. DESIGN: The patients presenting with imported malaria included in this study were hospitalised in the infectious and tropical diseases unit and in the pediatrics unit at the North University Hospital, from January 1, 2001 to December 31, 2003. Variables were prospectively collected and recorded. RESULTS: 352 patients including 240 adults and 112 children were included. Most of them (67% of the adults and 92% of the children) were contaminated during a trip to the Comoros Islands. Plasmodium falciparum was the most common species identified. 97.5% of adult and 98% of child patients back from Comoros did not take any chemoprophylaxis against malaria or took inadequate regimens. Halofantrin was the most commonly used drug for children to treat uncomplicated P. falciparum malaria. In adults, atovaquone-proguanil was used as a first line drug in the absence of vomiting, and a 3-day intravenous regimen of quinine-clindamycin in case of vomiting. CONCLUSION: The specificity of imported malaria in Marseilles is the high proportion of Comorian patients who go back home periodically to visit friends and relatives. A better education of the Comorian population in Marseilles, regarding malaria risks and prophylaxis, needs to be implemented.     

广西2010--2012年输入性疟疾流行病学分析

目的 分析2010－2012年广西壮族自治区（广西）输入性疟疾流行病学特点和趋势,为进一步提高疟疾控制后期输入性疟疾监测及诊治能力,保证2018年消除疟疾目标的实现提供科学依据。方法 收集2010－2012年广西全区输入性疟疾病例个案调查表、网络直报病例等监测数据,对输入性疟疾的感染来源、虫种、人群和地区分布,发病及诊治等进行描述和统计学分析。结果 3年来广西共报告国外和区外输入性疟疾病例397例,其中恶性疟261例,间日疟102例,三日疟7例,卵形疟3例,混合感染8例,未分型16例,死亡4例。病例主要分布在南宁、桂林、河池、百色、玉林和崇左6个地级市,占全区输入性疟疾病例数的92.70%（368/397）。男女性别比为55.7∶1,年龄分布集中在20～50岁组,农民和工人占病例总数的85.39%（339/397）。国外输入病例最多的是非洲加纳共212例,其次为缅甸68例,柬埔寨26例。结论 当前广西疟疾发病以国外输入性病例为主,且多数为恶性疟。输入性疟疾疫情严峻,为确保2018年广西消除疟疾目标的实现,应加强对外出非洲和东南亚地区务工返回人员疟疾监测,及时发现和有效治疗输入性传染源。     

1993～2008年烟台市疟疾发病情况分析

[目的]探讨烟台市疟疾基本消灭后期的流行特征,为现阶段疟防工作提供科学依据。[方法]对烟台市1993～2008年疟疾监测、疫情与调查资料进行分析。[结果]烟台市1993～2008年共发现疟疾病例130例,死亡1例,年发病率为0．05／10万～0．32／10万,年均发病率为0．12／10万。130例病例中,输人性病例占96．9％（126例）,其中来自国内省份的86例,来自国外的40例;恶性疟17例（占13．08％）。4例本地病例分布在海阳市（2例）,招远市（1例）,蓬莱市1例。输入性病例中,5～9月发病的占74．60%,本地病例均在6～8月发病。1993～2008年全市合计监测“三热”病人188722人次,检出疟原虫阳性病人101例,阳性率为0．05％。病例均为单发,未发生输人性继发病例。[结论]烟台市疟疾疫情持续保持在基本消灭疟疾的标准内,病例主要为输人性。     

Aspects of imported malaria at a district general hospital in non-endemic Kuwait,Arabian Gulf

There is no indigenous mosquito-borne transmission of malaria in Kuwait. However, in a five year period at a district general hospital, the number of laboratory-diagnosed cases of malaria increased annually from 25 to 84, a rise of 336%. Except for two induced infections, all were imported, mainly from the Indian subcontinent. Plasmodium vivax was responsible for 87.29% of the cases; P. falciparum (12.05%), a mixed infection of P. vivax and P. falciparum (0.33%) and a case of P. ovale (0.33%) were also identified. Rapid preparation of acetone-fixed, Giemsa-stained thick blood films, a heightened awareness of the infection, examination of multiple samples of blood from patients and the general resurgence of malaria in endemic areas were some of the factors responsible for the high number of cases diagnosed. Most patients were young males and presented with clinical malaria due to P. vivax between May and October each year, an apparent seasonal peak. However, many were already resident in the country for a variable period. Patients with P. falciparum though, presented clinically within two weeks of arrival in the country. Parasite densities were calculated to monitor the progress of treatment and identify quickly any possible chloroquine-resistant P. falciparum strains. A policy of active prophylaxis is suggested to stem the tide of imported malaria.Corresponding author.     

1984～2002年深圳市宝安区疟疾流行病学特征分析及防治探讨

目的 了解掌握宝安区疟疾发病情况在我区流行规律和变迁，为制定我区疟疾防治对策提供依据。方法 利用宝安区1984～2002年疫情汇编和宝安区统计局历年人口年鉴进行了回顾性调查，并作描述性研究分析。结果 在19年中疟疾发病病例数4962例。1995年以前以石场、砖厂、种菜、建筑工地人员为主，从1996年开始逐渐以工厂打工者为主(属输入性病例)。结论 1995年以前以本地感染病例为主，1995年以后以属输入性病例为主。     

Severe Malaria in Immigrant Population: A Retrospective Review

Imported malaria continues to be an increasing medical challenge in the US. A significant proportion of imported malaria occurs in foreign born immigrants visiting their native countries and do not take prophylaxis for malaria mostly due to a misconception of being immune to malaria. The purpose of this study is to review epidemiology, clinical presentation, rate of prophylaxis and delineate the rate of severe malaria in a community hospital with largely immigrant population. Retrospective chart review of forty patients diagnosed with malaria from 1997 to 2007 at a 673 bed teaching hospital in Newark, NJ, USA. Of the 40 cases included, 90% were born in a malaria endemic area (MEA).The Majority (85%) acquired malaria while visiting the African subcontinent. Overall prophylaxis rate was only 12%. Plasmodium falciparum was the most common malaria species diagnosed. Severe malaria was diagnosed in 25% of the cases, all in foreign born subjects visiting native countries where malaria is endemic. Malaria continues to be a challenge in a population of immigrants visiting their country of origin. Low use of prophylaxis is of major concern in immigrant population especially in light of high rates of severe malaria. Primary care physicians play an important role in pre-travel advice to prevent the complications of malaria.     

合肥市2008～2011年境外输入性疟疾流行病学分析

目的分析合肥市2008-2011年境外输入性疟疾流行病学特征与趋势,为制定防治措施提供依据。方法收集2008～2011年合肥市境外输入性疟疾病例疫情报告、流行病学调查表等资料,使用Excel软件和SPSS 13.0进行数据录入统计学分析。结果合肥市2008～2011年共报告境外输入性疟疾149例,恶性疟101例,死亡2例。男147例,女2例,民工、工人和农民占89.3%,发病数居前三位的分别为肥东县(占52.3%)、肥西县(占15.4%)和瑶海区(占12.8%)。148例病例来自非洲国家,1例来自柬埔寨。输入来源地居前三位的分别是:安哥拉73例(49.0%),赤道几内亚26例(17.4%),尼日利亚22例(14.7%),其他如喀麦隆、科特迪瓦、加纳等国家也有少数病例。结论合肥市境外输入性疟疾尤其是恶性疟发病呈逐年上升趋势,必须加强境外输入性疟疾病例的管理,特别是来自非洲高疟疾流行区人群的监测和病例管理。     

浙江省温州市两种输人性虫媒传染病监测分析

目的了解温州市登革热和疟疾等输入性虫媒传染病发病情况,为输入性传染病防控提供科学依据。方法对2004--2012年登革热和疟疾疫情进行流行病学分析,收集和分析登革热及疟疾监测资料。结果温州市累计报告输入性登革热病例11例,其中男性4例,女性7例。以孟加拉国和新加坡输入为主（8／11）;发病以6—11月为主,占81．82％。2010-2012年布雷图指数分别为14．65、18．43和16．98,6月布雷图指数最高。2004-2012年累计报告疟疾病例322例,其中间日疟242例,恶性疟71例,混合感染9例。疟疾病例中315例为输入性病例,其中境外输入占34．29％,境内输入占65．71％。血检“三热”患者157500例,感染率为0．20％。结论温州市存在登革热和疟疾输入风险及引起本地暴发的危险因素,应加强监测,采取针对性的防控措施,防止登革热和疟疾等输入性传染病暴发流行。     

铜陵市基本消灭疟疾后疟疾疫情分析及防治对策

目的分析铜陵市疟疾基本消灭后的疟疾疫情,以便进一步调整疟疾防治策略。方法对铜陵市1997～2003年疟疾防治监测报表等资料用流行病学统计方法进行汇总、核实、统计分析。结果7年共有66例疟疾病人,总发病率为2.72/10万,当地感染65例,外出感染病例1例,男女患者比例为42∶24。结论铜陵市近7年疟疾疫情一直较稳定,以当地感染为主。对疟疾病人进行正规治疗,对不明原因的发热病人血检疟原虫,从疟疾高发区回归人员预防性服药和对有疟史病例进行休根治疗,加强灭蚊防疟教育,是有效的防治疟疾的措施。     

2005～2009年玉林市疟疾流行特征分析

[目的]掌握低疟区疟疾发病规律,为防控工作提供科学依据。[方法]对玉林市2005～2009年疟疾发病调查资料进行分析。[结果]玉林市2005～2009年发现疟疾病人38例,均为输入性病人,其中外来人员11例,本地居民到有疟疾疫情地区打工感染27例;间日疟35例,恶性疟3例;2005年12例,2006年17例,2007年7例,2008年2例。5年合计,本地居民发热病人血检38337人,未发现疟原虫阳性者;在发生输入性疟疾病例的村屯（街道）周围人群中,血检疟原虫11784人均阴性,疟疾间接荧光抗体检测12186人阳性2人。[结论]玉林市2005～2009年发生的疟疾病例均为输入性病例。     

1970-2014年武汉市洪山区疟疾流行病学分析

目的 分析武汉市洪山区45年来疟疾病例的发病和流行特征,为巩固疟疾防治成果和制定防控措施提供科学依据。方法 对1970-2014年全区所有疟疾病例流行病学调查资料进行分析。结果 1970年发病率最高,后逐步下降,年度变化百分比为-40.84%。1980年发病率为93.82/10万,1986年为9.94/10万,以后呈现较低发病率趋势。2000年疟疾发病率下降至3.07/10万,之后一直维持在2/10万以下水平,2007年后所有疟疾病例均为输入病例。5-9月为发病高峰。病例男女性别比为2.91∶1,以20-29岁的青年人群发病数最多,占所有发病数的33.07%。本地感染以间日疟为主,输入性病例以感染恶性疟为主。结论 1970-2014年武汉市洪山区疟疾防治成效显著,但近年来输入性疟疾防控形势复杂,疾控机构应与相关部门加强合作,加大健康教育和防治培训力度,做好出国务工人员及流动人口管理和疾病监测。     

2005—2012年辽宁口岸输入性疟疾流行病学分析

目的掌握辽宁口岸输入性疟疾流行情况,为口岸输入性疟疾监测和防治工作提供科学依据。方法收集辽宁口岸2005—2012年输入性疟疾病例资料,以流行病学的方法分析其特点。结果2005—2012年共检出疟疾19例,均为输入性疟疾,检出率为3.60/10万。其发病无明显的季节性,临床多高热,以间日疟为主,其中11例患者有疟疾史。19例患者全部为男性,主要是中青年,多为劳务人员和船员,多数来自非洲及东南亚地区。结论根据辽宁输入性疟疾流行病学特征,检验检疫机构应及时掌握国内外疫情信息,加强口岸检疫查验、疾病监测,一旦发现疫情,及时采取有效的控制措施,防止输入性疟疾的播散。     

1991-2002年深圳市南山区疟疾流行特征分析

目的：分析深圳市南山区1991--2002年疟疾的流行趋势，为全区疟疾防治提供科学依据。方法根据深圳市法定传染病疫情报告订正数据、《南山区疫情资料汇编》及5例输入性恶性疟病例进行流行病学分析。结果：1991—2002年南山区疟疾年平均发病率6．02／10万，1992年发病率最高(17．16／1．0万)，1998—2002年疟疾年平均发病率1．94／10万；输入性恶性疟占同期疟疾发病数为27．78％，发病季节不明显；男性占发病数的80．87％，20～30岁青壮年占发病数的54．77％，工人占发病数的58．69％。结论：南山区疟疾疫情处于完全控制期，随着对外交流日益增多，境外输入性恶性疟疾发病增多。     

四川省疟疾流行态势与消除疟疾进展

目的分析四川省疟疾流行态势与消除疟疾工作进展情况。方法对全省疟疾发病与流行态势进行描述性研究。结果 1950-2012年四川省疟疾发病人数由最高时的58多万下降到近年的100余人,下降达99.98%以上,已连续19年年发病率控制在1/万以下;自2011年及以后全省本地疟疾病例报告均为0,即输入病例占总病例的100%;输入病例散在分布,全年均有发病,无明显季节分布;人群感染以男性为主（男：女=26.5：1）;职业以农民及农民工和工人为多（占72.25%）;年龄集中在青壮年（20-59岁）占95.15%;输入病例中,恶性疟占输入总病例的57.42%,主要输入地为非洲和东南亚。结论四川省疟疾发病大幅度下降,疟防进程已由控制阶段走向消除阶段。在此基础上,应进一步加强疟疾监测和流动人员管理,加快消除疟疾工作。     

2012 - 2018年贵州省输入性疟疾流行特征分析

目的 分析 2012 - 2018年贵州省输入性疟疾的流行特征,为制订疟疾防控策略和措施提供依据。方法 收集2012 - 2018年贵州省网络直报疟疾疫情数据,分析其流行病学特征。结果 （1）病例概况:2012 - 2018年贵州省累计报告疟疾病例164例,均为输入性病例,平均发病率0.67/10万,报告病例数均在十位数以内波动;（2）疾病分型:以恶性疟100例（60.98%）为主,其次间日疟50例（30.49%）、未分型14例（8.54%）;（3）人群分布:105例（64.02%）为男性,151例（92.07%）年龄分布于20～50岁,农民、工人、民工共105例（64.02%）;（4）时间分布:无明显的月发病高峰、季节性特征;（5）地区分布:82例（50%）患者分布于贵阳市、遵义市。结论 2012 - 2018年贵州省无本地疟疾病例,均为输入性病例,年增长趋势平稳,疟疾消除工作进入巩固阶段。输入性疟疾的防控是贵州省今后疟疾防控工作的重点和难点,应加强基层疟疾防控技能培训、医防协作及跨区域联防联控,以巩固消除疟疾取得的成果。     

2013 - 2018年合肥市境外输入性疟疾流行特征分析

目的 分析合肥市2013 - 2018年境外输入性疟疾流行趋势,为制定境外输入性疟疾防控措施提供科学依据。方法 收集合肥市2013 - 2018年境外输入性疟疾病例的相关资料,对时间、地区、人群分布,感染的虫种,就诊情况,感染来源等情况进行统计分析。结果 2013 - 2018年合肥市共计报告境外输入性疟疾病例460例,年平均发病率为0.98/10万,其中恶性疟368例,占80.0%。6月份报告的病例数最多,占15.7%;肥东县是发病数最多的地区,占55.4%;发病人群以31～50岁年龄组（75.9%）和男性为主（99.1%）;非洲国家（99.6%）是最主要的感染来源地。283例（61.5%）病例在境外有疟疾患病史;346例（75.2%）病例在初诊单位就得到了明确诊断。病例从发病到确诊的时间中位数为2 d。结论 虽然境外输入性疟疾发生数呈现下降趋势,合肥市疟疾防控形势仍然严峻。既要保持消除本地感染疟疾的成果,同时做好输入性性疟疾防控,应采取针对性的防控措施。     

Malaria in Poland in 2003

Seventeen cases of malaria were reported in Poland in 2003. All of them were imported: 13 from Africa, 2 from Asia and 1 from Indonesia. In 8 cases P. falciparum etiology was confirmed. Among the cases 14 were men and 3 were women. The youngest patient was 10 and the oldest 63, 11 of the patients were in the age group 21 to 40 years. Most commonly the reasons for travel were tourism or family visits (6 cases), professional (4 cases) and missionary (4 cases) travel. One death from falciparum malaria was reported in Poland in 2003. In 4 cases some kind of chemoprophylaxis was documented. In other prophylaxis was not used or not documented.     

Imported malaria (1985-95): trends and perspectives.

Malaria is frequently imported into nonendemic industrialized areas. In this study we collated data on the reported malaria cases in industrialized countries during the period 1985-95, with the object of identifying trends and promising strategies. The main outcome measures were incidence, case-fatality rates (CFRs), and attack rates in tourists returning from Kenya. Our survey showed gross underreporting and marked heterogeneity in the type and availability of national data. The total incidence or reported numbers of malaria infections in Europe increased from 6840 in 1985 to 7244 in 1995, with a peak of 8438 in 1989. The principal importing countries were France, Germany, Italy, and the United Kingdom. In the former USSR, the reported annual incidence dropped from 1145 in 1989 to 356 in 1990 after cessation of activities in Afghanistan. Among the imported species of malaria parasite, Plasmodium falciparum was identified in an increasing proportion, the CFR ranging from 0% to 3.6%, with consistently high rates in Germany. The attack rates among travellers to Kenya in 1990-95 were high, ranging from 18 to 207 per 100,000 travellers. Our findings indicate that in industrialized countries malaria is associated with a high CFR and remains a public health problem. Irregular surveillance and lack of homogeneity in the collected data hinder the assessment of incidences, risk groups, and the efficacy of chemoprophylaxis.     

Imported malaria in children: a national surveillance in the Netherlands and a review of European studies

BACKGROUND: Falciparum malaria or malaria tropica is one of the leading causes of childhood mortality worldwide. Malaria-related deaths occur mainly in sub-Saharan Africa, where an estimated 365 million clinical cases of Plasmodium falciparum malaria occur each year. In Europe, imported malaria cases occur due to returning travellers or immigration mostly from African countries. Children are more at risk than adults. The objective of this study was to identify high risk groups for imported childhood malaria in Europe in order to guide development of strategies for prevention, early recognition and management. METHODS: In the period May 2003-January 2005 we reviewed all cases of paediatric malaria in the Netherlands notified by the Dutch Paediatric Surveillance System (Nederland Signalerings Centrum Kindergeneeskunde, NSCK) and the literature on imported malaria in children in Europe published between 1996 and 2006. RESULTS: Malaria occurred mainly in children of long-term (n = 15, 47%) and new (n = 8, 25%) immigrants and was mostly acquired in sub-Saharan Africa. The dominant species was P. falciparum. Only one quarter of children had used adequate malaria chemoprophylaxis. Complicated disease occurred in 10 (31%) of cases. We also reviewed the literature and found 6082 reported cases of imported malaria among children in Europe; among these, four died and only one was reported to develop neurological sequelae. CONCLUSION: Imported malaria in children remains an important problem and is unlikely to decrease unless the reasons for inadequate prophylaxis are addressed.