Malaria and other febrile diseases among travellers: the experience of a reference centre located outside the Brazilian Amazon Region

Background Malaria is endemic in countries located in tropical and sub-tropical regions. The increasing flow of domestic and international travellers has made malaria a relevant health problem even in non-endemic regions. Malaria has been described as the main diagnosis among travellers presenting f...

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Vydáno v:Malaria journal Ročník 15; číslo 1; s. 294 - 11
Hlavní autoři: Dotrário, Andréa Beltrami, Menon, Lucas José Bazzo, Bollela, Valdes Roberto, Martinez, Roberto, de Almeida e Araújo, Daniel Cardoso, da Fonseca, Benedito Antônio Lopes, Santana, Rodrigo de C.
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 26.05.2016
BioMed Central Ltd
Springer Nature B.V
BMC
Témata:
Acute febrile illness
Adolescent
Adult
Aged
Aged, 80 and over
Analysis
Bilirubin
Biomedical and Life Sciences
Biomedicine
Brazil - epidemiology
Brazilian Amazon
Care and treatment
Cross-Sectional Studies
Diagnosis
Diagnostic Tests, Routine - methods
Disease transmission
Dosage and administration
Entomology
Female
Fever - diagnosis
Fever - epidemiology
Health aspects
Humans
Infectious Diseases
Malaria
Malaria - diagnosis
Malaria - epidemiology
Male
Microbiology
Middle Aged
Parasitology
Plasmodium falciparum
Plasmodium vivax
Prevalence
Prevention
Public Health
Retrospective Studies
Symptomatology
Travel
Travelers
Tropical environments
Tropical Medicine
Vector-borne diseases
Young Adult
Brazil
Brazilian Amazon
Acute febrile illness
Diagnosis
Malaria
Plasmodium falciparum
Plasmodium vivax
ISSN:1475-2875, 1475-2875
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Shrnutí:Background Malaria is endemic in countries located in tropical and sub-tropical regions. The increasing flow of domestic and international travellers has made malaria a relevant health problem even in non-endemic regions. Malaria has been described as the main diagnosis among travellers presenting febrile diseases after returning from tropical countries. In Brazil, malaria transmission occurs mainly in the Amazon region. Outside this area, malaria transmission is of low magnitude. Methods This cross-sectional study aimed to describe the experience in the diagnosis of malaria in a reference centre located outside the Brazilian Amazon Region, emphasizing the differences in clinical and laboratory markers between cases of malaria and those of other febrile diseases (OFD). Medical charts from adult patients (≥18 years) who underwent a thick smear test (TST) for malaria, between January 2001 and December 2014, were retrospectively reviewed. Results A total of 458 cases referred to perform the TST were included. Malaria was diagnosed in 193 (42 %) episodes. The remaining 265 episodes (58 %) were grouped as OFD. The majority of malaria episodes were acquired in the Brazilian Amazon Region. The median time between the onset of symptoms and the TST was 7 days. Only 53 (11.5 %) episodes were tested within the first 48 h after symptom onset. Comparing malaria with OFD, jaundice, nausea, vomiting, and reports of fever were more prevalent in the malaria group. Low platelet count and elevated bilirubin levels were also related to the diagnosis of malaria. Conclusions The results indicate that outside the endemic area travellers presenting febrile disease suspected of being malaria underwent diagnostic test after considerable delay. The reporting of fever combined with a recent visit to an endemic area should promptly evoke the hypothesis of malaria. In these cases, specific diagnostic tests for malaria should be a priority. For cases that jump this step, the presence of elevated bilirubin or thrombocytopaenia should also indicate a diagnosis of malaria.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1475-2875
1475-2875
DOI:10.1186/s12936-016-1347-x