Cabezos J, Durán E, Treviño B, Bada J L
Institut Català de la Salut, Departamento de Genética y Microbiología, Facultad de Medicina, Universidad Autónoma de Barcelona.
Med Clin (Barc). 1995 Jan 21;104(2):45-8.
The aim of the present study was to analyze the epidemiologic aspects and particular features of malaria in immigrants in Catalonia, Spain.
All the immigrants who visited the Unit of Tropical and Imported Diseases "Drassanes" in Barcelona from endemic zones of malaria from 1990 to 1993 were studied. The diagnosis of malaria was based on the thick blood film, peripheral blood smear exam and, since 1991, the QBC (Quantitative Buffy Coat).
One hundred three cases of malaria were diagnosed in 100 individuals from a total of 2,453 visited immigrants. Forty-four percent of the patients presented febrile syndrome, 11% cutaneous syndrome accompanied by other manifestations justifying the same, 9% presented other clinical manifestations and 36% were asymptomatic. Ninety-six percent of the subjects with parasites by Plasmodium were from sub-Saharan Africa and in 2 cases, both were produced by Plasmodium falciparum, with the length of time having been in Spain at the time of diagnosis being more than one year. P. falciparum represented 70% of the total cases, followed by P. malariae (15%), P. vivax (8%), Plasmodium spp. (6%) and P. ovale (1%).
Malaria by P. falciparum in semi-immune immigrants is not usually severe and follows an asymptomatic course in more than one third of the cases. The usual analysis for Plasmodium is recommended in immigrants from sub-Saharan Africa due to the high frequency of presentation and the absence of symptoms. Such analysis is not advised in groups from other areas except when suggestive symptoms are present.
本研究旨在分析西班牙加泰罗尼亚地区移民中疟疾的流行病学特征及特殊情况。
对1990年至1993年期间从疟疾流行区前往巴塞罗那“Drassanes”热带及输入性疾病科就诊的所有移民进行研究。疟疾诊断基于厚血膜、外周血涂片检查，自1991年起还采用定量血沉棕黄层（QBC）检查。
在总共2453名就诊移民中的100人身上诊断出103例疟疾。44%的患者出现发热综合征，11%出现皮肤综合征并伴有其他相应表现，9%出现其他临床表现，36%无症状。疟原虫感染者中96%来自撒哈拉以南非洲，2例由恶性疟原虫引起，诊断时在西班牙的停留时间超过一年。恶性疟原虫占总病例的70%，其次是三日疟原虫（15%）、间日疟原虫（8%）、疟原虫属（6%）和卵形疟原虫（1%）。
半免疫移民中的恶性疟通常并不严重，超过三分之一的病例呈无症状病程。鉴于撒哈拉以南非洲移民中疟疾的高发率及无症状情况，建议对其进行常规疟原虫分析。除有提示性症状外，不建议对其他地区人群进行此类分析。
