意大利前往疟疾流行国家旅行者疟疾的发病率和危险因素。

Incidence of malaria and risk factors in Italian travelers to malaria endemic countries.

机构信息

Istituto Superiore di Sanità, Department of Infectious, Parasitic and Immuno-mediated Diseases, Vector-Borne Diseases and International Health Unit, Viale Regina Elena, 299, 00161 Rome, Italy.

出版信息

Travel Med Infect Dis. 2010 May;8(3):144-54. doi: 10.1016/j.tmaid.2010.02.001. Epub 2010 Mar 4.

DOI:10.1016/j.tmaid.2010.02.001

PMID:20541134

Abstract

BACKGROUND

Imported malaria has been an increasing problem in Italy in the last three decades of the 1900s, representing the main risk for travelers visiting tropical and sub-tropical countries where malaria is endemic. Even though the total number of imported cases has been declining since 2000, malaria still represents the most frequent notifiable imported disease in Italy. The present study analyzes all the malaria cases reported in Italy in 2000-2006 in order to assess the trend of incidence over the time and reviewing the risk factors for travelers visiting malaria endemic countries.

METHODS

All 2000-2006 case report forms were analyzed. The incidence of malaria in Italian travelers was calculated by continent and by countries most visited, using data provided by the Ministry of Transportation.

RESULTS

Out of the 5219 malaria cases reported and confirmed in the study period five were autochthonous and 5214 imported, 1518 of which occurred in Italian citizen and 3696 in foreigners. Between 2000 and 2006 imported malaria cases fell from 977 to 630 respectively, with a total reduction of about 36%. Most of the cases were contracted in Africa (93%) and Plasmodium falciparum was the etiological agent in 83% of the cases, with an annual average fatality rate of about 0.5%. The average of the crude incidence rate (CIR) among Italians was calculated by continent for both global cases (gCIR) and for P. falciparum cases (pfCIR) resulting of 1.2/1000 and 0.9 for Africa, 0.08/1000 and 0.02 for Asia, 0.03/1000 and 0.003 for Central and South America, respectively. The gCIR by continent slightly but decreased constantly over the study period.

DISCUSSION

The different factors which may influence the risk of contracting malaria for travelers visiting endemic countries and the strategy to reduce completely the number of fatal cases were considered and discussed.

摘要

背景

在 20 世纪最后三十年，输入性疟疾已成为意大利的一个日益严重的问题，这对前往疟疾流行地区旅行的人构成了主要威胁。尽管自 2000 年以来输入性疟疾病例总数一直在下降，但疟疾仍是意大利最常见的需报告的输入性疾病。本研究分析了 2000-2006 年期间报告的所有意大利疟疾病例，以评估随时间推移发病率的趋势，并审查前往疟疾流行国家旅行的旅行者的风险因素。

方法

分析了所有 2000-2006 年的病例报告表。使用交通部提供的数据，按大陆和最受欢迎的国家计算了意大利旅行者的疟疾发病率。

结果

在所研究期间报告并确诊的 5219 例疟疾病例中，有 5 例为本地疟疾病例，5214 例为输入性疟疾病例，其中 1518 例为意大利公民，3696 例为外国人。2000 年至 2006 年，输入性疟疾病例从 977 例降至 630 例，总降幅约为 36%。大多数病例发生在非洲（93%），83%的病例病原体为恶性疟原虫，年病死率约为 0.5%。按大陆计算，意大利人的粗发病率（CIR）平均值为全球病例（gCIR）和恶性疟原虫病例（pfCIR），结果分别为非洲的 1.2/1000 和 0.9，亚洲的 0.08/1000 和 0.02，中美洲和南美洲的 0.03/1000 和 0.003。研究期间，gCIR 略有下降，但持续下降。