title: Imported malaria including HIV and pregnant woman risk groups: overview of the case of a Spanish city 2004-2014.
abstract: BACKGROUND
  Arrival of inmigrants from malaria endemic areas has led to a emergence of cases of this parasitic disease in Spain. The objective of this study was to analyse the high incidence rate of imported malaria in Fuenlabrada, a city in the south of Madrid, together with the frequent the lack of chemoprophylaxis, for the period between 2004 and 2014. Both pregnant women and HIV risk groups have been considered.
  
  
  METHODS
  Retrospective descriptive study of laboratory-confirmed malaria at the Fuenlabrada University Hospital, in Madrid, during a 10-year period (2004-2014). These data were obtained reviewing medical histories of the cases. Relevant epidemiological, clinical and laboratory results were analysed, with focus on the following risk groups: pregnant women and individuals with HIV.
  
  
  RESULTS
  A total of 185 cases were diagnosed (90.3 % Plasmodium falciparum). The annual incidence rate was 11.9/100,000 inhabitants/year. The average age was 30.8 years (SD: 14.3). Infections originating in sub-Saharan Africa comprised the 97.6 % of the cases. A total of 85.9 % were Visiting Friends and Relatives. Only a 4.3 % completed adequate prophylaxis. A total of 14.28 % of the fertile women were pregnant, and 8 cases (4.3 %) had HIV. None of them in these special groups completed prophylaxis.
  
  
  CONCLUSIONS
  The incidence rate in Fuenlabrada is higher than in the rest of Spain, due to the large number of immigrants from endemic areas living in the municipality. However, the results are not representative of all the country. It seems to be reasonable to implement prevention and pre-travel assessment programs to increase chemoprophylaxis. Pregnancy tests and HIV serology should be completed for all patients to improve prophylactic methods.
authors.affiliation: Department of Internal Medicine, Fuenlabrada University Hospital, Fuenlabrada, C/Camino del Molino, 2, Zip Code 28942, Fuenlabrada, Madrid, Spain. fdzlopezm@gmail.com.|Rey Juan Carlos University, Alcorcón, Madrid, Spain. fdzlopezm@gmail.com.
authors.forename: María
authors.initials: M
authors.lastname: Fernández López
authors.affiliation: Department of Internal Medicine, Fuenlabrada University Hospital, Fuenlabrada, C/Camino del Molino, 2, Zip Code 28942, Fuenlabrada, Madrid, Spain. josemanuel.ruiz@salud.madrid.org.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Ruiz Giardín
authors.affiliation: Department of Internal Medicine, Fuenlabrada University Hospital, Fuenlabrada, C/Camino del Molino, 2, Zip Code 28942, Fuenlabrada, Madrid, Spain. jsanmartin.hflr@salud.madrid.org.
authors.forename: Juan Víctor
authors.initials: JV
authors.lastname: San Martín López
authors.affiliation: Department of Microbiology, Fuenlabrada Universtiy Hospital, Fuenlabrada, Madrid, Spain. jeronimo.jaqueti@salud.madrid.org.
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Jaquetti
authors.affiliation: Department of Microbiology, Fuenlabrada Universtiy Hospital, Fuenlabrada, Madrid, Spain. mgarata@salud.madrid.org.
authors.forename: Isabel
authors.initials: I
authors.lastname: García Arata
authors.affiliation: Doctors Without Borders, Madrid, Spain. carolina.jimenez@gmail.com.
authors.forename: Carolina
authors.initials: C
authors.lastname: Jiménez Navarro
authors.affiliation: San Carlos Clinical Hospital, Madrid, Spain. ncabello@salud.madrid.org.
authors.forename: Noemi
authors.initials: N
authors.lastname: Cabello Clotet
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000368:Aged; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology* / Q000469:parasitology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010961:Plasmodium / Q000302:isolation & purification*; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011159:Population Surveillance; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012621:Seasons; D013030:Spain / Q000453:epidemiology; D055815:Young Adult