Clinical and Laboratory Features of Travel-associated Malaria: A University Hospital Experience

Abstract

Introduction: Malaria remains an ongoing challenge despite the fact that it seems to have been eradicated in Turkey since 2011. This study aimed to evaluate the status of antimalarial prophylaxis, clinical and laboratory profile of imported malaria cases admitted to a university hospital in a period of 10 years. Materials and Methods: Patients with malaria hospitalized in a university hospital between the years 2008 and 2017 were evaluated retrospectively. Data were obtained from the hospital database. Thin and thick blood smears were examined for diagnosis. Sociodemographic features, epidemiological, clinical, and laboratory findings as well as response to various treatments were evaluated. Results: A total of 20 patients (all male) were diagnosed with imported malaria. The median age of the patients was 35 (19-56) years. The median length of travel was 78 (6-545) days. Plasmodium falciparum was the most common causative agent (80%). Only one patient had received malaria prophylaxis previously. Fever was the most prominent symptom (95%). C-reactive protein (CRP) levels were higher than 100 mg/dl in 75% (n=15) of patients. Eight cases were re-hospitalized with relapse and/or recrudescence. CRP levels in patients with relapse and/or recrudescence were significantly higher. All the patients received combination regimen. The most commonly used anti-malarial drugs were artemisinin derivatives. Conclusion: Before visiting malaria-endemic regions it is essential to obtain information about preventive measures and chemoprophylaxis. Sick patients should be monitored until full resolution of symptoms and also peripheral blood smear should be performed due to the high rate of relapses. CRP can be a useful biomarker in follow-up of patients infected with malaria.