National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain.
National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain; Microbiology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain.
Travel Med Infect Dis. 2022 Sep-Oct;49:102411. doi: 10.1016/j.tmaid.2022.102411. Epub 2022 Aug 3.
Up to 40% of cases of imported malaria in Europe are diagnosed in recently arrived migrants, who generally exhibit asymptomatic or mild symptoms and show low parasitaemia (submicroscopic). The study describes the prevalence of malaria infection among asymptomatic Sub-Saharan African migrants (ASSAM) and compares asymptomatic malaria-infected (AMI) vs non-malaria infected patients.
An observational, comparative, retrospective study was carried out in ASSAM who underwent a medical examination, between 2010 and 2019 at the National Reference Unit for Tropical Diseases (NRU-Trop) in Madrid, Spain. Medical examination and systematic screening protocol for infectious diseases, including screening for malaria infection by Polymerase Chain Reaction (PCR) was performed.
During the study period, 632 out of 1061 ASSAM were screened for malaria, median age: 24 years (IQR:1-5); median time from arrival to diagnosis: 2 months (IQR:1-5). P. falciparum was the most frequent species: 61 patients (67.8%). Compared to non-malaria infected, AMI subjects had: higher rate of co-infection with S. stercoralis (41.1%VS 22.9%;p < 0.001) and filariae (8.9% VS 2.4%;p = 0.006), lower erythrocyte corpuscular volume (83.6 VS 84.4;p = 0.008) and lower levels of cholesterol (151.0 VS 167.3;p < 0.001).
We observed a high prevalence of AMI among ASSAM. This highlights the need to consider routing screening of migrants from endemic areas and to study if such screening could avoid the potential morbidities associated with chronic infection, reduce morbi-mortality of acute malaria and the risk of transmission in host communities.
在欧洲，多达 40%的输入性疟疾病例是在最近抵达的移民中诊断出来的，这些移民通常表现为无症状或轻度症状，且寄生虫血症（亚微观）较低。本研究描述了撒哈拉以南非洲无症状移民（ASSA）中的疟疾感染患病率，并比较了无症状疟疾病例（AMI）与非疟疾病例。
这是一项在西班牙马德里国家热带病参考单位（NRU-Trop）接受医学检查的无症状撒哈拉以南非洲移民（ASSA）中进行的观察性、对比性、回顾性研究。进行了医学检查和系统传染病筛查方案，包括通过聚合酶链反应（PCR）筛查疟疾感染。
在研究期间，对 1061 名 ASSA 中的 632 人进行了疟疾筛查，中位年龄为 24 岁（IQR：1-5）；从到达至诊断的中位时间为 2 个月（IQR：1-5）。最常见的疟原虫是恶性疟原虫：61 例（67.8%）。与非疟疾病例相比，AMI 患者：合并感染旋毛虫的比例更高（41.1% VS 22.9%；p < 0.001）和丝虫（8.9% VS 2.4%；p = 0.006），红细胞体积（83.6 VS 84.4）和胆固醇水平（151.0 VS 167.3）更低（均 p < 0.001）。
我们观察到 ASSA 中存在高比例的 AMI。这突显出有必要考虑对来自流行地区的移民进行常规筛查，并研究这种筛查是否可以避免与慢性感染相关的潜在发病和死亡率，降低急性疟疾的发病率和宿主社区的传播风险。
