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T R, C D, A R, Jc Y. Nine years of imported malaria in a teaching hospital in Belgium: Demographics, clinical characteristics, and outcomes. Diagn Microbiol Infect Dis 2024; 108:116206. [PMID: 38335879 DOI: 10.1016/j.diagmicrobio.2024.116206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/06/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Imported malaria is often misdiagnosed due to the aspecific symptoms and lack of familiarity among clinicians. This study aims to evaluate a decade-long trend of imported malaria cases in a Belgian teaching hospital by analyzing demographics, clinical characteristics, and outcomes. METHODS Medical records of 223 patients with confirmed malaria diagnoses between 2010 and 2019 were analyzed. RESULTS Most patients were male (63.2%), aged 18-65 years (77.1%), and visiting friends or relatives (40.8%). Central Africa was the most common travel destination (54.3%), and 63.7% did not take prophylaxis. Symptoms were flu-like, with fever (91.9%) being most prevalent. P. falciparum was identified in 88.3% of cases. A high proportion of severe cases (41.7%) and a low mortality rate (0.9%) were recorded. A severe form of the disease is associated with a more extended hospital stay than uncomplicated form (median of 5 vs. 4 days, p < 0.001). Thirty-five-point five percent [33/93] of patients with severe malaria have had a previous malaria infection compared to 50.8% [66/130] of uncomplicated patients (p= 0.013) wich was statistically significant. CONCLUSION Malaria disproportionately affects VFRs traveling to Central Africa, and flu-like symptoms should raise suspicion. Prophylaxis is essential to prevent the disease, and early diagnosis is critical for effective management. A severe form of the disease is associated with a more extended hospital stay than uncomplicated form and people with a previous history of malaria have a less severe disease.
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Affiliation(s)
- Ratovonjanahary T
- Epidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Danwang C
- Clinton Health Access Initiative, Inc., Boston, MA, USA
| | - Robert A
- Epidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Yombi Jc
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
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Bosilkovski M, Khezzani B, Poposki K, Semenakova-Cvetkovska V, Vidinic I, Lloga AO, Jakimovski D, Dimzova M. Epidemiological and clinical characteristics of imported falciparum malaria in the Republic of North Macedonia : A 13-year experience. Wien Klin Wochenschr 2023; 135:609-616. [PMID: 37010597 DOI: 10.1007/s00508-023-02192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Plasmodium falciparum is the leading cause of imported malaria and the most common cause of death in returning travellers. AIM To identify the main epidemiological and clinical characteristics of patients with imported falciparum malaria in the Republic of North Macedonia. MATERIAL AND METHODS 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. RESULTS 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%). CONCLUSION In every febrile traveller returned from Africa, imported falciparum malaria should be an essential part of differential diagnostic considerations.
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Affiliation(s)
- Mile Bosilkovski
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Bachir Khezzani
- Department of Biology, Faculty of Natural and Life Sciences, University of El Oued, PO Box 789, 39000, El Oued, Algeria.
- Laboratory of Biology, Environment and Health (LBEH), Faculty of Natural and Life Sciences, University of El Oued, PO Box 789, 39000, El Oued, Algeria.
| | - Kostadin Poposki
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Vesna Semenakova-Cvetkovska
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Ivan Vidinic
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Arlinda Osmani Lloga
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Dejan Jakimovski
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Marija Dimzova
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
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Odeniran PO, Ademola IO, Jegede HO. A review of wildlife tourism and meta-analysis of parasitism in Africa's national parks and game reserves. Parasitol Res 2018; 117:2359-2378. [PMID: 29948206 DOI: 10.1007/s00436-018-5958-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 06/05/2018] [Indexed: 12/14/2022]
Abstract
The recent increase of parasitic diseases associated with wildlife tourism can be traced to human contact with wildlife and intense modification of wildlife habitat. The continental estimates of parasitic diseases among visited wildlife-tourists and mammalian wildlife present in conservation areas are lacking; therefore, a general review was necessary to provide insights into Africa's parasitic disease burden and transmission between humans and wildlife. A two-step analysis was conducted with searches in Ovid MEDLINE, EMBASE, PubMed, Web of Science and Global Health. All diseases reported without prevalence were grouped and analysed as categorical data while meta-analysis of prevalence rates of parasitic diseases in wildlife from national parks and reserves in Africa was conducted. Only 4.7% of the tourist centres reported routine wildlife diagnosis for parasitic diseases. Disease intensity shows that cryptosporidiosis and seven other parasitic diseases were observed in both human and wildlife; however, no significant difference in intensity between human and wildlife hosts was observed. Schistosomiasis intensity reports showed a significant increase (P < 0.05) while entamoebiasis showed a significant decrease (P < 0.05) in humans as compared to wildlife. Visiting tourists were more infected with malaria, while wildlife was more infected with parasitic gastroenteritis (PGE). The meta-analysis of wildlife revealed the highest prevalence of PGE with mixed parasites and lowest prevalence of Giardia spp. at 99.9 and 5.7%, respectively. The zoonotic and socioeconomic impact of some of these parasites could pose a severe public threat to tourism. Pre- and post-travel clinical examinations are important for tourists while routine examination, treatment and rational surveillance are important for these animals to improve wildlife tourism.
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Affiliation(s)
- Paul Olalekan Odeniran
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Isaiah Oluwafemi Ademola
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
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Rojas-Velázquez L, Morán P, Serrano-Vázquez A, Fernández LD, Pérez-Juárez H, Poot-Hernández AC, Portillo T, González E, Hernández E, Partida-Rodríguez O, Nieves-Ramírez ME, Magaña U, Torres J, Eguiarte LE, Piñero D, Ximénez C. Genetic Diversity and Distribution of Blastocystis Subtype 3 in Human Populations, with Special Reference to a Rural Population in Central Mexico. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3916263. [PMID: 29744356 PMCID: PMC5878905 DOI: 10.1155/2018/3916263] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/11/2018] [Indexed: 02/01/2023]
Abstract
Blastocystis subtype 3 (ST3) is a parasitic protist found in the digestive tract of symptomatic and asymptomatic humans around the world. While this parasite exhibits a high prevalence in the human population, its true geographic distribution and global genetic diversity are still unknown. This gap in knowledge limits the understanding of the spread mechanisms, epidemiology, and impact that this parasite has on human populations. Herein, we provided new data on the geographical distribution and genetic diversity of Blastocystis ST3 from a rural human population in Mexico. To do so, we collected and targeted the SSU-rDNA region in fecal samples from this population and further compared its genetic diversity and structure with that previously observed in populations of Blastocystis ST3 from other regions of the planet. Our analyses reveled that diversity of Blastocystis ST3 showed a high haplotype diversity and genetic structure to the world level; however, they were low in the Morelos population. The haplotype network revealed a common widespread haplotype from which the others were generated recently. Finally, our results suggested a recent expansion of the diversity of Blastocystis ST3 worldwide.
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Affiliation(s)
- Liliana Rojas-Velázquez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
- Unidad de Posgrado, Universidad Nacional Autónoma de México (UNAM), Circuito de Posgrado S/N, Coyoacán, Cd. Universitaria, 04510 Ciudad de México, Mexico
| | - Patricia Morán
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
| | - Angélica Serrano-Vázquez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
| | - Leonardo D. Fernández
- Centro de Investigación en Recursos Naturales y Sustentabilidad (CIRENYS), Universidad Bernardo O'Higgins, Avenida Viel 1497, Santiago, Chile
| | - Horacio Pérez-Juárez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
- Unidad de Posgrado, Universidad Nacional Autónoma de México (UNAM), Circuito de Posgrado S/N, Coyoacán, Cd. Universitaria, 04510 Ciudad de México, Mexico
| | - Augusto C. Poot-Hernández
- Departamento de Ingeniería de Sistemas Computacionales y Automatización, Sección de Ingeniería de Sistemas Computacionales, Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México (UNAM), Circuito Escolar 3000, Cd. Universitaria, Coyoacán, 04510 Ciudad de México, Mexico
| | - Tobías Portillo
- Unidad de Bioinformática, Bioestadística y Biología Computacional, Red de Apoyo a la Investigación, Coordinación de la Investigación Científica, UNAM, Instituto Nacional de Ciencias Médicas y Nutrición, Vasco de Quiroga 15, Tlalpan, 14080 Ciudad de México, Mexico
| | - Enrique González
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
| | - Eric Hernández
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
| | - Oswaldo Partida-Rodríguez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
| | - Miriam E. Nieves-Ramírez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
| | - Ulises Magaña
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
- Unidad de Posgrado, Universidad Nacional Autónoma de México (UNAM), Circuito de Posgrado S/N, Coyoacán, Cd. Universitaria, 04510 Ciudad de México, Mexico
| | - Javier Torres
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatría, Centro Médico Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Avenida Cuauhtémoc 330, Doctores, Cuauhtémoc, 06720 Ciudad de México, Mexico
| | - Luis E. Eguiarte
- Departamento de Ecología Evolutiva, Instituto de Ecología, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Junto al Jardín Botánico, Cd. Universitaria, Coyoacán, 04510 Ciudad de México, Mexico
| | - Daniel Piñero
- Departamento de Ecología Evolutiva, Instituto de Ecología, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Junto al Jardín Botánico, Cd. Universitaria, Coyoacán, 04510 Ciudad de México, Mexico
| | - Cecilia Ximénez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Dr. Balmis 148, Doctores, Cuauhtémoc, 06726 Ciudad de México, Mexico
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