Malaria in Poland in 2014-2018.

OBJECTIVE

Assessment of the epidemiological situation of imported malaria in Poland in 2014-2018 in comparison with the situation in previous years.

MATERIAL AND METHODS

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).

RESULTS

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.

CONCLUSIONS

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.