西班牙输入性疟疾（2009-2016 年）：+REDIVI 合作网络的研究结果。
Imported malaria in Spain (2009-2016): results from the +REDIVI Collaborative Network.
机构信息
National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain.
Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain.
出版信息
Malar J. 2017 Oct 10;16(1):407. doi: 10.1186/s12936-017-2057-8.
BACKGROUND
Imported malaria is a frequent diagnosis in travellers and migrants. The objective of this study was to describe the epidemiological and clinical characteristics of patients diagnosed with imported malaria within a Spanish collaborative network registering imported diseases (+REDIVI). In addition, the possible association between malaria and type of case, gender, age or area of exposure was explored.
METHODS
Cases of imported malaria were identified among all cases registered in the +REDIVI database during the period October 2009-October 2016. Demographic, epidemiological and clinical characteristics were analysed.
RESULTS
In total, 11,816 cases of imported infectious diseases were registered in +REDIVI's database between October 2009 and October 2016. Immigrants seen for the first time after migration accounted for 60.2% of cases, 21.0% of patients were travellers, and 18.8% were travellers/immigrants visiting friends and relatives (VFRs). There were 850 cases of malaria (850/11,816, 7.2%). Malaria was significantly more frequent in men than in women (56.8% vs 43.2%) and in VFR-immigrants (52.6%) as compared to travellers (21.3%), immigrants (20.7%) and VFR-travellers (5.4%) (p < 0.001). Although this data was not available for most patients with malaria, only a minority (29/217, 13.4%) mentioned correct anti-malarial prophylaxis. Sub-Saharan Africa was found to be the most common region of acquisition of malaria. Most common reason for consultation after travel was a febrile syndrome although an important proportion of immigrants were asymptomatic and presented only for health screening (27.3%). Around 5% of travellers presented with severe malaria. The most prevalent species of Plasmodium diagnosed was Plasmodium falciparum (81.5%). Malaria due to Plasmodium ovale/Plasmodium vivax was frequent among travellers (17%) and nearly 5% of all malaria cases in immigrants were caused by Plasmodium malariae.
CONCLUSIONS
Malaria was among the five most frequent diagnoses registered in +REDIVI's database. Some significant differences were found in the distribution of malaria according to gender, type of case, species. Among all malaria cases, the most frequent diagnosis was P. falciparum infection in VFR-immigrant men.
背景
输入性疟疾是旅行者和移民中常见的诊断。本研究的目的是描述在一个注册输入性疾病的西班牙合作网络（+REDIVI）中诊断为输入性疟疾的患者的流行病学和临床特征。此外，还探讨了疟疾与病例类型、性别、年龄或暴露地区之间的可能关联。
方法
在 2009 年 10 月至 2016 年 10 月期间，从+REDIVI 数据库中登记的所有输入性传染病病例中确定输入性疟疾病例。分析人口统计学、流行病学和临床特征。
结果
在 2009 年 10 月至 2016 年 10 月期间，+REDIVI 数据库中登记了 11816 例输入性传染病病例。首次移民后就诊的移民占病例的 60.2%，旅行者占 21.0%，旅行者/移民探亲访友（VFR）占 18.8%。有 850 例疟疾（850/11816，7.2%）。男性疟疾发病率明显高于女性（56.8%比 43.2%），VFR 移民（52.6%）也高于旅行者（21.3%）、移民（20.7%）和 VFR 旅行者（5.4%）（p<0.001）。尽管大多数疟疾患者的数据无法获得，但只有少数（29/217，13.4%）患者提到了正确的抗疟预防措施。撒哈拉以南非洲是疟疾最常见的感染地区。旅行后就诊的最常见原因是发热综合征，但相当一部分移民无症状，仅因健康筛查而就诊（27.3%）。约 5%的旅行者出现严重疟疾。诊断出的最常见疟原虫是恶性疟原虫（81.5%）。卵形疟原虫/间日疟原虫在旅行者中很常见（17%），移民中近 5%的所有疟疾病例都是由疟原虫引起的。
结论
疟疾是+REDIVI 数据库中登记的五个最常见诊断之一。根据性别、病例类型、物种的不同，疟疾的分布存在一些显著差异。在所有疟疾病例中，VFR 移民男性中最常见的诊断是恶性疟原虫感染。
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