Bosilkovski Mile, Khezzani Bachir, Poposki Kostadin, Semenakova-Cvetkovska Vesna, Vidinic Ivan, Lloga Arlinda Osmani, Jakimovski Dejan, Dimzova Marija
University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia.
Department of Biology, Faculty of Natural and Life Sciences, University of El Oued, PO Box 789, 39000, El Oued, Algeria.
Wien Klin Wochenschr. 2023 Nov;135(21-22):609-616. doi: 10.1007/s00508-023-02192-6. Epub 2023 Apr 3.
Plasmodium falciparum is the leading cause of imported malaria and the most common cause of death in returning travellers.
To identify the main epidemiological and clinical characteristics of patients with imported falciparum malaria in the Republic of North Macedonia.
Retrospectively analyzed were the epidemiological and clinical features of 34 patients with imported falciparum malaria who were diagnosed and treated at the university clinic for infectious diseases and febrile conditions in Skopje from 2010 to 2022. Malaria diagnosis was based on the microscopic detection of parasites in thick and thin blood smears.
All patients were male, with a median age of 36 years and a range of 22-60 years. Of the patients 33 (97.1%) acquired the disease in Sub-Saharan Africa. All patients except one stayed in endemic regions for work/business purposes. Chemoprophylaxis was completely applied in 4 (11.8%) patients. The median time of onset between the symptoms and diagnosis was 4 days, with a range of 1-12 days. Prevailing clinical manifestations were fever, chills, and splenomegaly in 100%, 94%, and 68% of patients, respectively. Severe malaria was noticed in 8 (23.5%) patients. In 5 (14.7%) patients the initial parasitemia was higher than 5%. On admission, thrombocytopenia, hyperbilirubinemia, and elevated alanine aminotransferase were registered in 94%, 58%, and 62% of patients, respectively. Out of the 33 patients with adequate follow-up, the outcome was favorable in 31 (93.9%).
In every febrile traveller returned from Africa, imported falciparum malaria should be an essential part of differential diagnostic considerations.
恶性疟原虫是输入性疟疾的主要病因，也是归国旅行者最常见的死亡原因。
确定北马其顿共和国输入性恶性疟疾病例的主要流行病学和临床特征。
回顾性分析了2010年至2022年期间在斯科普里大学传染病与发热疾病诊所诊断并接受治疗的34例输入性恶性疟疾病例的流行病学和临床特征。疟疾诊断基于厚薄血涂片显微镜下寄生虫检测。
所有患者均为男性，年龄中位数为36岁，范围在22至60岁之间。其中33例（97.1%）患者在撒哈拉以南非洲感染该病。除1例患者外，所有患者均因工作/商务目的前往疟疾流行地区。4例（11.8%）患者全程进行了化学预防。症状出现至诊断的中位时间为4天，范围为1至12天。主要临床表现分别为：发热占100%、寒战占94%、脾肿大占68%。8例（23.5%）患者出现重症疟疾。5例（14.7%）患者初始寄生虫血症高于5%。入院时，94%的患者出现血小板减少、58%的患者出现高胆红素血症、62%的患者出现丙氨酸转氨酶升高。在33例得到充分随访的患者中，31例（93.9%）预后良好。
对于每一位从非洲归来的发热旅行者，输入性恶性疟疾都应作为鉴别诊断的重要考虑因素。
