Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
J Travel Med. 2014 May-Jun;21(3):189-94. doi: 10.1111/jtm.12109. Epub 2014 Mar 13.
The number of imported malaria cases in Poland compared with other European countries remains low. However, in view of the high mortality and the large proportion of severe clinical forms, a better understanding of the problem is required.
Data reported to the surveillance system in Poland between 2003 and 2011 were reviewed retrospectively. All cases were laboratory confirmed as outlined by the EU case definition. Statistical analysis was performed using Epi Info 3.5.3 and STATA 10.
A total of 189 confirmed malaria cases, including 5 that were fatal, were reported in Poland during the study period. All cases were imported: 72% came from Africa. Among cases with a species-specific diagnosis, 118 (73%) were caused by Plasmodium falciparum. The median age of individuals afflicted was 36 years and 74% were males. Most cases occurred among work-related travelers (40%) or tourists (38%). Individuals born in malaria-endemic countries constituted 12% of all cases. The severe malaria form was identified in 23% of all cases and was more frequent among cases caused by P. falciparum (32%), in people older than 50 years (39%), and in cases when diagnosis was delayed (36%). The severe form occurred only in 9% of cases originating from malaria-endemic countries and there were no fatalities in this group. Fatal outcomes were associated with a delay in diagnosis (fatality = 10.5%) and falciparum malaria (fatality = 4%). Most of the delays resulted from a delay in seeking medical care, and less frequently due to misdiagnosis.
Tourists and work-related travelers make up most of the malaria patients in Poland and they are at a greater risk of the severe form of malaria and consequently death, possibly due to the lack of immunity. Delayed diagnosis is associated with mortality, implying low awareness of the threat that malaria poses, both among patients and doctors.
与其他欧洲国家相比，波兰的输入性疟疾病例数量仍然较低。然而，鉴于高死亡率和大量严重临床形式的存在，需要更好地了解这一问题。
回顾性审查了 2003 年至 2011 年期间向波兰监测系统报告的数据。所有病例均按欧盟病例定义进行实验室确认。使用 Epi Info 3.5.3 和 STATA 10 进行统计分析。
在研究期间，波兰共报告了 189 例确诊疟疾病例，其中 5 例死亡。所有病例均为输入性病例：72%来自非洲。在具有种特异性诊断的病例中，118 例（73%）由恶性疟原虫引起。受感染者的中位年龄为 36 岁，74%为男性。大多数病例发生在工作相关旅行者（40%）或游客（38%）中。在所有病例中，出生于疟疾流行国家的个体占 12%。所有病例中有 23%为重症疟疾，在由恶性疟原虫引起的病例中更为常见（32%），在 50 岁以上的人群中（39%），以及在诊断延迟的情况下（36%）更为常见。在来自疟疾流行国家的病例中，仅 9%出现重症，且该组无死亡病例。死亡结局与诊断延迟（死亡率=10.5%）和恶性疟（死亡率=4%）有关。大多数延误是由于寻求医疗护理的延误，而较少是由于误诊。
游客和工作相关旅行者构成了波兰疟疾患者的大部分，他们更有可能患上严重的疟疾，因此死亡的风险更高，这可能是由于缺乏免疫力。诊断延迟与死亡率相关，这意味着患者和医生对疟疾构成的威胁的认识较低。
