新冠大流行期间输入性疟疾的流行趋势，西班牙（+Redivi 协作网络）。

Trends in imported malaria during the COVID-19 pandemic, Spain (+Redivi Collaborative Network).

机构信息

National Referral Unit for Tropical Diseases, Infectious Diseases Department. Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.

Unitat de Medicina Tropical y Salut Internacional Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.

出版信息

J Travel Med. 2022 Sep 17;29(6). doi: 10.1093/jtm/taac083.

DOI:10.1093/jtm/taac083

PMID:35876259

Abstract

INTRODUCTION

The COVID-19 pandemic has caused disruptions in prevention and management strategies for malaria globally. Currently, data analysing trends in travel-related infections during the pandemic years are scarce. The objective of this analysis was to describe the epidemiological and clinical characteristics of patients with imported malaria within the +Redivi network in Spain, focusing on yearly trends from pre-pandemic years to date.

METHODS

Cases recorded in +Redivi from October 2009 to December 2021 were analysed and patients with a diagnosis of malaria (standard diagnostic methods using thick/thin peripheral blood smears, with/without a malaria rapid diagnostic test and/or Plasmodium spp. polymerase chain reaction) were identified. The total number of malaria cases, cases according to type of patient and severe cases, per year, were analysed.

RESULTS

In total, 1751 cases of malaria (1751/26 601, 6.6%) were identified. The majority occurred in males (1041, 59.5%), median age was 36.3 (interquartile range: 27-44.7) years and most occurred in visiting friends and relatives (VFR)-immigrants (872, 49.8%). Most infections were acquired in sub-Saharan Africa (1.660, 94.8%) and were due to Plasmodium falciparum (81.3%). There were 64 cases of severe malaria (3.7%) and 4 patients died (0.2% mortality, all in pre-pandemic years). A significant increase in cases of severe malaria was observed during the study period (P < 0.001) (attributable to the increase in 2021). There were 16/93 severe cases in 2021 (17.2%), all due to Plasmodium falciparum, (compared with ≤ 5% in previous years), which mainly occurred in travellers and VFR-immigrants (10/16, 62.5% and 5/16, 31.3%, respectively).

CONCLUSIONS

After an initial decline associated with travel restrictions due to the ongoing COVID-19 pandemic, an increase in imported malaria and a significant increase in cases of severe malaria was observed. Patients with imported malaria may present and/or be diagnosed late during this public health crisis and health care professionals should be alerted to the recent increase in severe cases.

摘要

简介

COVID-19 大流行在全球范围内扰乱了疟疾的预防和管理策略。目前，有关大流行期间与旅行相关感染趋势的数据分析很少。本分析的目的是描述西班牙+Redivi 网络内输入性疟疾患者的流行病学和临床特征，重点分析大流行前年份至今的年度趋势。

方法

分析了 2009 年 10 月至 2021 年 12 月期间在+Redivi 记录的病例，并确定了诊断为疟疾的患者（使用厚/薄外周血涂片、有/无疟疾快速诊断检测和/或疟原虫聚合酶链反应的标准诊断方法）。每年按患者类型和重症病例分析疟疾总病例数、病例数。

结果

共发现 1751 例疟疾（1751/26601，6.6%）。大多数病例发生在男性（1041 例，59.5%），中位年龄为 36.3 岁（四分位距：27-44.7），大多数为探亲访友（VFR）移民（872 例，49.8%）。大多数感染发生在撒哈拉以南非洲（1660 例，94.8%），由恶性疟原虫（81.3%）引起。有 64 例严重疟疾（3.7%），4 例死亡（0.2%死亡率，均发生在大流行前年份）。研究期间严重疟疾病例显著增加（P<0.001）（归因于 2021 年的增加）。2021 年有 16 例/93 例严重病例（17.2%），均由恶性疟原虫引起（与前几年的≤5%相比），主要发生在旅行者和 VFR-移民中（16 例中的 10 例，62.5%和 16 例中的 5 例，31.3%）。