Stępień Małgorzata
National Institute of Public Health - National Institute of Hygiene in Warsaw, Department of Epidemiology of Infectious Diseases and Surveillance
Przegl Epidemiol. 2019;73(2):201-209. doi: 10.32394/pe.73.19.
Assessment of the epidemiological situation of imported malaria in Poland in 2014-2018 in comparison with the situation in previous years.
The analysis of data on malaria cases included in individual reports sent to the Department of Epidemiology of NIPH-NIH by sanitary-epidemiological stations and aggregate data published in annual bulletins “Infectious diseases and poisonings in Poland” was carried out. Reported cases were classified according to the criteria of the case definition applicable in EU countries (2012/506 / EU).
In 2014-2018, a total of 141 cases of malaria were registered in Poland, all cases were imported from malaria-endemic countries. The lowest number of cases reported in 2014 (19 cases), and the highest in 2016 (38 cases), the median number of cases in the period 2014-2018 was 28 and was by 27% higher than in the previous 5-year period. The incidence in the observed period was 0.7 per 1 million population and case fatality rate 3.6% (5 deaths per 140 cases with known outcome). Patients were aged 18-74 years, median age was 38 years, males accounted for 72% of all patients. In 89% of cases, infection was acquired in African countries and Cameroon was the most frequently mentioned among countries of exposure. Species of Plasmodium was determined in 90% of invasions, of which P. falciparum accounted for 78%. Most of malaria patients registered in Poland travelled for tourism/leisure (45%, 56/124) or business (43%, 53/124). People visiting the country of origin (visiting friends and relatives, VFR) accounted for 10% of patients for whom the purpose of the trip was known. The mean time of diagnostic delay between the onset of symptoms and the diagnosis was 6 days.
In recent years, there has been an increase in the number of malaria cases in Poland compared to previous years, but the total number of cases remains low. After a few years of low fatality rate, the number of deaths due to malaria increased again, likewise the number of cases with diagnostic delays (> 3 days after the onset of symptoms) and severe disease. The obtained data indicate the need to strengthen activities that raise the awareness of travellers on available prophylaxis and need to remind primary healthcare doctors about an extended anamnesis including travel history and the consideration of malaria in diagnosing of a febrile patient.
评估2014 - 2018年波兰输入性疟疾的流行病学情况，并与往年情况作比较。
对卫生流行病学站发送至国家公共卫生研究所（NIPH - NIH）流行病学部的各份报告中所包含的疟疾病例数据，以及《波兰的传染病与中毒》年度公报中公布的汇总数据进行分析。报告的病例根据适用于欧盟国家（2012/506/EU）的病例定义标准进行分类。
2014 - 2018年，波兰共登记了141例疟疾病例，所有病例均从疟疾流行国家输入。2014年报告的病例数最少（19例），2016年最多（38例），2014 - 2018年期间病例数的中位数为28例，比前一个5年期间高出27%。观察期内的发病率为每100万人口0.7例，病死率为3.6%（已知转归的140例病例中有5例死亡）。患者年龄在18 - 74岁之间，中位年龄为38岁，男性占所有患者的72%。在89%的病例中，感染发生在非洲国家，喀麦隆是提及最多的暴露国家。90%的侵袭病例确定了疟原虫种类，其中恶性疟原虫占78%。波兰登记的大多数疟疾病例是因旅游/休闲出行（45%，56/124）或商务出行（43%，53/124）。已知出行目的的患者中，探亲访友（VFR）占10%。症状出现至诊断之间的平均诊断延迟时间为6天。
近年来，波兰疟疾病例数与往年相比有所增加，但病例总数仍然较低。在经历了几年的低病死率之后，疟疾死亡人数再次增加，诊断延迟（症状出现后>3天）和重症病例的数量也是如此。所获得的数据表明，有必要加强提高旅行者对现有预防措施认识的活动，并提醒基层医疗医生在问诊时要包括旅行史，并在诊断发热患者时考虑疟疾。
