Abstract

Objective: Plasmodium falciparum acquired abroad, has become the main causative malaria agent in Turkey due to the elimination of endemic P. vivax in recent years. By describing clinical, laboratory and treatment features of imported malaria cases caused by P. falciparum, we aimed to distinguish it from other infectious diseases with similar epidemiological and clinical features, such as viral haemorrhagic fevers, and therefore to ensure the recognition of this kind of deadly malaria earlier.

Methods: All cases hospitalized in Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University with a diagnosis of malaria between 2000 and 2016 were included in the study. Epidemiological, clinical, laboratory features and antimalarial drugs used either for prophylaxis or treatment of the cases were retrieved from the hospital database retrospectively.

Results: A total of 16 patients diagnosed as having malaria caused by P. falciparum were followed our clinic during the study period. Apart from one patient who had visited Afghanistan, all of the cases acquired the infection during an Africa visit. Except two patients who received irregular prophylaxis, none of the patients had used prophylactic drugs for prevention of malaria. All of the patients had fever and shaking chills. The most frequently encountered pathologic laboratory findings were thrombocytopenia and elevated serum LDH levels. Of the patients, 50% had severe malaria and 31% were followed in intensive care unit. Artemether-lumefantrine was the most frequent (44%) regimen for treatment. All patients were discharged with full recovery except one lost due to cerebral malaria.

Conclusions: Patients who acquired malaria abroad are most likely to acquire a more severe form of the disease because of the lack of the antibodies resulting from previous exposure. To avoid this severe disease, it is important to give more attention to appropriate prophylaxis against malaria among persons who plan to visit endemic areas. 

Klimik Dergisi 2017; 30(3): 120-5.

Cite this article as: Başaran S, Şimşek-Yavuz S, Çağatay A, Öncül O, Özsüt H, Eraksoy H. [Imported malaria caused by Plasmodium falciparum: a global problem]. Klimik Derg. 2017; 30(3): 120-5. Turkish.