[Imported malaria in a general hospital in Madrid].
BACKGROUND
To study the clinical and epidemiological characteristics of malaria and the diagnosis of this condition in a general hospital that does not have a specialized tropical medicine unit.


METHODS
Retrospective study of all malaria cases diagnosed by thick film and/or PCR-positive status for any Plasmodium spp. from 1999 to 2003 in Hospital Príncipe de Asturias in Alcalá de Henares (Madrid, Spain).


RESULTS
Over the period studied, 89 cases of malaria were diagnosed. Most patients were African immigrants who had recently left their countries of origin (52%), or immigrants residing in Spain who had traveled to Africa for a short visit (35%) and did not take prophylaxis. The distribution of cases by species was Plasmodium falciparum 89%, P. ovale 7% and P. malariae 4%. Clinical data were non-specific and the percentage of severe complications was low (6.7%). A second-generation test for rapid detection of P. falciparum antigen (PfHRP2) was studied in a group of 46 patients with suspected malaria; the results obtained were similar to thick film as compared to PCR for diagnosing P. falciparum infection.


CONCLUSIONS
Access to information on prevention and chemoprophylaxis should be available to all travelers, particularly immigrants visiting their countries of origin. Most semi-immune patients with uncomplicated malaria can be treated on an outpatient basis. PfHRP2 antigen detection, a fast, reliable method for diagnosing malaria due to P. falciparum, can be used in addition to the thick film method in our setting.
Rojo-Marcos
Gerardo
G
Servicios de Medicina Interna, Hospital Príncipe de Asturias, Madrid, España. grojo.hupa@salud.madrid.org
Cuadros-González
Juan
J
Gete-García
Luis
L
Prieto-Ríos
Blanca
B
Arcos-Pereda
Pilar
P
D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004641:Emigration and Immigration; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000175:diagnosis / Q000453:epidemiology; D010961:Plasmodium / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000469:parasitology; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014195:Travel
D000962:Antimalarials