Aoun K, Siala E, Tchibkere D, Ben Abdallah R, Zallagua N, Chahed M K, Bouratbine A
Laboratoire de parasitologie, Institut Pasteur de Tunis, Tunisie.
Med Trop (Mars). 2010 Feb;70(1):33-7.
Although malaria has been eradicated in Tunisia since 1979, the disease is still a health issue due to the persistence of mosquitoes and coexistence with a potential parasite reservoir in the form of imported cases. From 1999 to 2006, 98 cases of imported malaria were diagnosed at the Pasteur Institute in Tunis where nearly 30% of national cases are recorded. Tunisians accounted for 24.5% of these cases versus 75.5% involving foreigners. The occurrence rate has steadily increased in volunteer workers, businessmen, diplomats and athletes who together accounted for 41.7% of cases in 1995 as compared to only 17.4% in 1980 (p<0.01). Most cases (96.5%) were imported from sub-Saharan Africa. The most frequent countries involved in importation were Cote d'Ivoire (23 cases) and Mali (8 cases) that are now linked to Tunisia by regular flights. About one third of patients were asymptomatic at the time of diagnosis. This finding underlines the importance of recommending systematic screening in high-risk groups. Fever (70.6%) and gastro-intestinal manifestations (27.9%) were the most frequent clinical findings in the 69 symptomatic cases. Plasmodium falciparum (71.4%) was the most common species followed by Plasmodium ovale (19.4%). Gametocytes were detected in 9.2% of subjects, thus creating a theoretical source of infection for mosquitoes especially since 60.2% of all cases were recorded between June and October when mosquitoes are active in Tunisia. Due to increasing exchange with endemic malaria areas in Africa that has resulted in a higher incidence of imported cases and a futher risk of introduction of tropical mosquito species as well as to global warming that promotes plasmodium transmission, greater vigilance is necessary to ensure eradication of malaria in Tunisia.
尽管自1979年以来突尼斯已根除疟疾，但由于蚊子的持续存在以及与以输入病例形式存在的潜在寄生虫宿主共存，该疾病仍是一个健康问题。1999年至2006年，突尼斯巴斯德研究所诊断出98例输入性疟疾病例，该国近30%的疟疾病例在此记录。这些病例中，突尼斯人占24.5%，外国人占75.5%。志愿者、商人、外交官和运动员中的发病率稳步上升，他们在1995年占病例的41.7%，而1980年仅为17.4%（p<0.01）。大多数病例（96.5%）是从撒哈拉以南非洲输入的。输入病例最常见的国家是科特迪瓦（23例）和马里（8例），目前这两个国家与突尼斯有定期航班相连。约三分之一的患者在诊断时无症状。这一发现强调了对高危人群进行系统筛查的重要性。在69例有症状的病例中，发热（70.6%）和胃肠道表现（27.9%）是最常见的临床症状。恶性疟原虫（71.4%）是最常见的种类，其次是卵形疟原虫（19.4%）。9.2%的受试者检测到配子体，因此为蚊子创造了理论上的感染源，特别是因为所有病例的60.2%记录在6月至10月之间，此时突尼斯的蚊子活跃。由于与非洲疟疾流行地区的交流增加，导致输入病例的发病率上升，以及引入热带蚊种的进一步风险，以及全球变暖促进疟原虫传播，因此需要提高警惕，以确保突尼斯根除疟疾。
