意大利弗留利-威尼斯朱利亚大区三家主要医院输入性疟疾的流行病学和临床特征

Epidemiological and clinical features of imported malaria at the three main hospitals of the Friuli-Venezia Giulia Region, Italy.

作者信息

Stano Paola, Arzese Alessandra, Merelli Maria, Mascarello Marta, Maurel Cristina, Avolio Manuela, Bassetti Matteo, De Rosa Rita, Luzzati Roberto, Modolo Maria Luisa, Scarparo Claudio, Camporese Alessandro

机构信息

Clinical Microbiology and Virology Laboratory, Department of Laboratory Medicine, Azienda per l'Assistenza Sanitaria N.5 "Friuli Occidentale", Hospital of Pordenone, Via Montereale, 24, 33170 Pordenone, Italy.

Microbiology Laboratory Unit, Azienda Sanitaria Universitaria Integrata, Santa Maria della Misericordia University Hospital, Piazzale Santa Maria Della Misericordia, 15, 33100, Udine, Italy; Department of Medicine, University of Udine, Piazzale Kolbe, 4, 33100 Udine, Italy.

出版信息

Infect Dis Health. 2018 Mar;23(1):17-22. doi: 10.1016/j.idh.2017.08.007. Epub 2017 Oct 13.

DOI:10.1016/j.idh.2017.08.007

PMID:30479299

Abstract

BACKGROUND

Imported malaria cases continue to occur in non-endemic regions among travellers returning from tropical and subtropical countries. At particular risk of acquiring malaria is the group of travellers identified as immigrants who return to their home country with the specific intent of visiting friends or relatives (VFRs) and who commonly believe they are immune to malaria and fail to seek pre-travel advice. Our aim was to review the current trends of imported malaria in the three main hospitals of the Friuli-Venezia Giulia region (FVG), North Eastern Italy, focusing in particular on patient characteristics and laboratory findings.

METHODS

In this retrospective study, we examined all malaria cases among patients admitted from January 2010 through December 2014 to the emergency department of the three main hospitals located in FVG.

RESULTS

During the 5-year study period from 2010 to 2014, there were a total of 140 patients with a diagnosis of suspected malaria and who received microscopic confirmation of malaria. The most common species identified was P. falciparum, in 96 of 140 cases (69%), followed by P. vivax (13%), P. ovale (4%), P. malariae (4%), and mixed infection (4%). The most common reason for travel was VFRs (54%), followed by work (17%), and recent immigration (15%). Moreover, 78% of all patients took no chemoprophylaxis, 80 (79%) of whom were foreigners. Notably, the percentage of Italian travellers who took chemoprophylaxis was only 20% (8 of 39 Italian cases), and the regimen was appropriate in only four cases. Parasitaemia greater than 5% was observed in 11 cases (10%), all due to P. falciparum infection.

CONCLUSIONS

We highlight that VFRs have the highest proportion of malaria morbidity and the importance of improving patient management in this category. These data are useful for establishing appropriate malaria prevention measures and recommendations for international travellers.

摘要

背景

在从热带和亚热带国家返回的旅行者中，非疟疾流行地区仍不断出现输入性疟疾病例。有一类旅行者感染疟疾的风险尤其高，即那些以探亲访友为特定目的回国的移民（VFRs），他们通常认为自己对疟疾有免疫力，因而未寻求旅行前的建议。我们的目的是回顾意大利东北部弗留利-威尼斯朱利亚大区（FVG）三家主要医院输入性疟疾的当前趋势，尤其关注患者特征和实验室检查结果。

方法

在这项回顾性研究中，我们检查了2010年1月至2014年12月期间入住FVG三家主要医院急诊科的所有疟疾病例。

结果

在2010年至2014年的5年研究期间，共有140例被诊断为疑似疟疾且经显微镜确诊为疟疾的患者。鉴定出的最常见疟原虫种类是恶性疟原虫，140例中有96例（69%），其次是间日疟原虫（13%）、卵形疟原虫（4%）、三日疟原虫（4%）和混合感染（4%）。旅行的最常见原因是探亲访友（54%），其次是工作（17%）和近期移民（15%）。此外，所有患者中有78%未采取化学预防措施，其中80例（79%）为外国人。值得注意的是，采取化学预防措施的意大利旅行者比例仅为20%（39例意大利病例中的8例），且只有4例预防方案恰当。11例（10%）观察到寄生虫血症大于5%，均由恶性疟原虫感染所致。