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Epidemiological features and case management practices of imported malaria in northern Italy 1991–1995
Author(s) -
Matteelli A.,
Colombini P.,
Gulletta M.,
Castelli F.,
Carosi G.
Publication year - 1999
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.1999.00468.x
Subject(s) - malaria , medicine , chemoprophylaxis , epidemiology , case fatality rate , incidence (geometry) , mefloquine , quinine , plasmodium falciparum , pediatrics , retrospective cohort study , surgery , immunology , physics , optics
Summary We report the results of a retrospective analysis of the clinical charts of imported malaria cases notified during the period 1991–95 in the Lombardy region of northern Italy. We analysed 694 admissions related to 683 individuals. The proportion of immigrants increased during the observation period from 34.4% in 1991 to 59.9% in 1995 ( P = 0.002). P. falciparum was the causative species in 534 cases (78.2%), and 591 (90.1%) of 656 cases with a full travel history had travelled to Africa. Information on chemoprophylaxis was available in 604 cases: 429 (71.0%) reported no drug intake, 140 (23.2%) an incomplete, and 35 (5.8%) a complete chemoprophylactic course. The proportion of subjects who had initiated malaria chemoprophylaxis was significantly lower among immigrants (7.4%) than nonimmigrants (50.2%) ( P < 0.001). Severe disease was diagnosed in 26 (4.7%) of 551 cases of falciparum malaria, with a significantly lower incidence among immigrants (1.3% vs . 9.2%; P < 0.001). Eight deaths were recorded, all among nonimmigrants, whose fatality rate was significantly higher ( P = 0.02). Mefloquine treatment of cases of uncomplicated falciparum malaria was associated with a significantly shorter fever clearance time (2.8 days ± 1.5 vs . 3.5 days ± 1.9; P < 0.001) and mean hospital stay (5.9 days ± 4.4 vs . 8.3 days ± 5.1; P < 0.001) compared to quinine treatment.