title: Imported Plasmodium falciparum malaria in Istanbul, Turkey: risk factors for severe course and mortality.
abstract: We describe the epidemiological, clinical features and risk factors for the morbidity and mortality of imported Plasmodium falciparum malaria cases during the last 10 years in Istanbul, Turkey. The epidemiological, clinical and laboratory data of cases in six tertiary care hospitals in Istanbul between 2002 and 2012 were analysed. Seventy patients (65 males, five females; median age 37; range: 14-84) were included. Sixty-five (93%) patients had travelled to African countries and the remaining five to other malarious countries. Seventeen (24%) had a history of previous malarial episodes; eight (13%) developed recrudescence during the first month; 22 (31%), 17 (24%), 20 (29%) and three (4%) cases had cerebral malaria, cholestatic icterus, malarial hepatitis and respiratory distress syndrome on admission, respectively. Six of 12 patients with severe falciparum malaria died. Clinically, the presence of alteration in mental status, icterus, hypoglycaemia, disseminated intravascular coagulation and malarial hepatitis were statistically significant for the development of severe malaria and mortality. Recrudescence should not be forgotten, especially in uncomplicated cases.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Tem Avrupa otoyolu Göztepe Çıkışı No.1, Bağcılar 34214, Istanbul, Turkey. ferhatarslandr@hotmail.com.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Arslan
authors.forename: Ali
authors.initials: A
authors.lastname: Mert
authors.forename: Ayse
authors.initials: A
authors.lastname: Batirel
authors.forename: Asuman
authors.initials: A
authors.lastname: Inan
authors.forename: Ilker Inanc
authors.initials: II
authors.lastname: Balkan
authors.forename: Ozcan
authors.initials: O
authors.lastname: Nazlican
authors.forename: Cengiz
authors.initials: C
authors.lastname: Uzun
authors.forename: Haluk
authors.initials: H
authors.lastname: Vahaboglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014195:Travel; D014421:Turkey; D055815:Young Adult
keywords: Plasmodium falciparum; cholestasis; icterus; malaria