Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait, Kuwait.
PLoS One. 2020 Dec 11;15(12):e0243617. doi: 10.1371/journal.pone.0243617. eCollection 2020.
Malaria still continues to be the most important parasitic disease worldwide, affecting 228 million people and causing 405,000 deaths each year. In this retrospective study during 2013 to 2018, we documented the incidence of imported malaria infection and evaluated the impact of malaria preventive measures in Kuwait, a non-endemic country. The epidemiologic and demographic data of all malaria cases was collected from the Infectious Diseases Hospital, Kuwait where all suspected cases of malaria are referred for confirmation and therapeutic intervention. The diagnosis of malaria infection was done by microscopy of Giemsa stained blood films. Selected samples were retested with BinaxNOW® Malaria rapid test and molecular assay to reconfirm the Plasmodium spp. or mixed infection. Overall, 1913 (25.9%) malaria cases were detected, 81.5% of which were among male subjects. Male subjects had higher incidence of P. vivax malaria (113; 91.1%) and mixed infection with P. falciparum and P. vivax (1245; 90.0%) compared to females who had higher rate of P. falciparum infection (52.4%). An overwhelming majority of malaria cases (1895; 99.1%) were detected among expatriates from malaria-endemic countries; India (1012; 52.9%), Pakistan (390; 20.4%), Afghanistan (94; 4.9%) and African countries (313; 16.3%). Only 18 cases involved Kuwaiti nationals, all with a history of travel to African countries. The majority of malaria cases were detected during the summer and fall months (May-October). Our data showed that the incidence rate of imported malaria cases was stable during 2013 to 2018, however, the incidence of total malaria cases showed a declining trend over the years. This study confirms that the preventive program has been successful in reducing the incidence of imported malaria infections in Kuwait. The most striking finding of this study was high incidence of mixed infection with P. falciparum and P. vivax, with almost all (97%) cases among workers from India.
疟疾仍然是全球最重要的寄生虫病，每年影响 2.28 亿人，导致 40.5 万人死亡。在 2013 年至 2018 年期间进行的这项回顾性研究中，我们记录了科威特（一个非疟疾流行国家）输入性疟疾感染的发病率，并评估了疟疾预防措施的效果。所有疟疾病例的流行病学和人口统计学数据均从科威特传染病医院收集，所有疑似疟疾的病例都被转诊以确认和进行治疗干预。疟疾感染的诊断通过吉姆萨染色血片显微镜检查进行。选择的样本用 BinaxNOW®疟疾快速检测和分子检测进行重新检测，以重新确认疟原虫属或混合感染。总体而言，共发现 1913 例（25.9%）疟疾病例，其中 81.5%为男性。男性的间日疟原虫疟疾发病率较高（113 例；91.1%），且疟原虫属和间日疟原虫混合感染率较高（1245 例；90.0%），而女性的恶性疟原虫感染率较高（52.4%）。绝大多数（1895 例；99.1%）疟疾病例是在来自疟疾流行国家的移民中发现的；印度（1012 例；52.9%）、巴基斯坦（390 例；20.4%）、阿富汗（94 例；4.9%）和非洲国家（313 例；16.3%）。只有 18 例涉及科威特国民，均有前往非洲国家的旅行史。大多数疟疾病例是在夏季和秋季（5 月至 10 月）发现的。我们的数据显示，2013 年至 2018 年期间，输入性疟疾病例的发病率保持稳定，但多年来总疟疾病例的发病率呈下降趋势。本研究证实，预防计划已成功降低了科威特输入性疟疾感染的发病率。本研究最显著的发现是恶性疟原虫和间日疟原虫混合感染率较高，几乎所有（97%）病例均来自印度的工人。
