Sánchez Beatriz Soto, Tato L M Prieto, Martín S Guillén, Pérez E, Grasa C, Valderrama S, Augusto I de, Sierra M, Ros M García, Aguado I, Hortelano M García López
Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain.
Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain.
Enferm Infecc Microbiol Clin. 2017 Jun-Jul;35(6):348-353. doi: 10.1016/j.eimc.2016.11.014. Epub 2017 Feb 23.
The majority of malaria cases diagnosed in Europe in the last few years have occurred in people living in non-endemic areas travelling back to their home country to visit friends and relatives (VFRs). Children account for 15-20% of imported malaria, with known higher risk of severe disease.
A retrospective multicentre study was conducted in 24 hospitals in Madrid (Spain) including patients under 16 years diagnosed with malaria (2007-2013).
A total of 149 episodes in 147 children were reported. Plasmodium falciparum was the species most commonly isolated. Twenty-five patients developed severe malaria and there was one death related to malaria. VFR accounted for 45.8% of our children. Only 17 VFRs had received prophylaxis, and 4 of them taken appropriately. They presented more frequently with fever (98% vs. 69%), a longer time with fever (55 vs. 26%), delay in diagnosis of more than three days (62 vs. 37%), and more thrombocytopenia (65 vs. 33%) than non-VFRs, and with significant differences (p<0.05).
VFRs represent a large proportion of imported malaria cases in our study. They seldom took adequate prophylaxis, and delayed the visit to the physician, increasing the length of fever and subsequent delaying in diagnosis. Appropriate preventive measures, such as education and pre-travel advices should be taken in this population.
过去几年在欧洲确诊的大多数疟疾病例发生在居住在非疟疾流行地区、回国探亲访友的人（探亲访友者）中。儿童占输入性疟疾病例的15%-20%，且已知其患重症疾病的风险更高。
在西班牙马德里的24家医院开展了一项回顾性多中心研究，纳入2007-2013年确诊为疟疾的16岁以下患者。
共报告了147名儿童的149次发病情况。恶性疟原虫是最常分离出的疟原虫种类。25名患者发展为重症疟疾，有1例与疟疾相关的死亡病例。探亲访友者占我们研究中儿童病例的45.8%。只有17名探亲访友者接受了预防措施，其中4人预防措施得当。与非探亲访友者相比，他们发热更为频繁（98%对vs. 69%）、发热时间更长（55天对vs. 26天）、诊断延迟超过三天的情况更多（62%对vs. 37%）以及血小板减少症更多见（65%对vs. 33%），且差异具有统计学意义（p<0.05）。
在我们的研究中，探亲访友者占输入性疟疾病例的很大比例。他们很少采取充分的预防措施，并延迟就医，从而增加了发热时长及随后的诊断延迟。应对这一人群采取适当的预防措施，如开展教育和提供旅行前建议。
