Raccurt C P, Le Bras M, Cuisinier-Raynal J C, Ripert C, Carteron B
Service de Parasitologie, Université de Bordeaux III.
Med Trop (Mars). 1990 Jan-Mar;50(1):75-83.
100 cases of imported malaria were registered in Hospitals of Bordeaux in 1987 and 85 in 1988. Origin of infestation is Africa in 88 p.c. of the cases mainly from Central Africa (50 p.c.) in 1987 and western Africa (67 p.c.) in 1988. The most frequent species was Plasmodium falciparum 73 p.c. in 1987 and 82 p.c. in 1988. Admitted cases in Bordeaux were mainly French (81 p.c.) with a significant male prevailing and young adults. Mean age was 29 for Europeans and 19 for the others mainly Africans. Infestation risk is in close correlation with the duration of stay in endémic zones. It is maximum for stays between 2 and 11 months. Delay for first symptoms to appear following return from an endemic zone depends of species concerned during the first month, 83 p.c. of malaria fever at Plasmodium falciparum during the second quarter, 50 p.c. of fever at Plasmodium vivax, and after one year or more 40 p.c. at Plasmodium ovale. Only 1/4 of the cases were diagnosed during the first 48 hours. Delay in diagnosing may be prolonged and is in relationship with Plasmodium falciparum chemoresistance and self-medication. 21 strains of Plasmodium falciparum were chloroquinoresistant in vitro: 1 from French Guyana, 9 from Western Africa, and 11 from Central Africa. The strain from Guyana was also less sensible to quinine with a IC 50 = 480 nmol/l.
1987年,波尔多各医院登记了100例输入性疟疾病例,1988年为85例。感染源88%来自非洲,1987年主要来自中非(50%),1988年来自西非(67%)。最常见的疟原虫种类是恶性疟原虫,1987年占73%,1988年占82%。在波尔多收治的病例主要是法国人(81%),男性占比显著且以年轻人为主。欧洲人的平均年龄为29岁,其他人主要是非洲人,平均年龄为19岁。感染风险与在疫区停留的时间密切相关。在疫区停留2至11个月时感染风险最高。从疫区返回后首次出现症状的延迟时间取决于第一个月感染的疟原虫种类,恶性疟原虫感染后第二季度83%出现疟疾发热,间日疟原虫感染后50%出现发热,卵形疟原虫感染一年或更长时间后40%出现发热。只有四分之一的病例在最初48小时内被诊断出来。诊断延迟可能会延长,这与恶性疟原虫的化学抗性和自我用药有关。21株恶性疟原虫在体外对氯喹耐药:1株来自法属圭亚那,9株来自西非,11株来自中非。来自圭亚那的菌株对奎宁也不太敏感,其半数抑制浓度(IC50)=480纳摩尔/升。