Malaria in non-endemic Kuwait: resident status of patients with imported infections and the need for prophylaxis.

Kuwait is non-endemic for malaria but, with a large expatriate population, the number of imported infections has escalated from 87 in 1980 to 534 in 1984, an increase of over 613%. During a period of 1 year at the Infectious Diseases Hospital, where most of the cases were diagnosed each year, 16.7% of blood samples sent for microscopy were positive for malaria; 95.47% of these patients were hospitalized for an average of 4 days. In a 2-year period, only three (0.52%) Kuwaiti nationals imported the infection out of a total of 577 patients with malaria. About equal numbers of expatriate 'residents' and 'new arrivals' were responsible for the remainder, but over 80% of patients with Plasmodium falciparum were 'residents'. The proportion of residents among the patients is increasing and will be more pronounced with the downturn in the economy. To curtail the tide of imported malaria, the current data suggests the viability of an active campaign to offer chemoprophylaxis to travellers at risk who are essentially 'semi-immune visitors of a non-malarious area visiting a malarious area'. The benefits of simple prophylactic measures need to be emphasized. The disinfection of aircraft arriving from endemic zones should be mandatory.