Imported Plasmodium vivax malaria ex Pakistan

Area of Science:

• Global Health
• Infectious Diseases
• Travel Medicine

Background:

• Pakistan reports 1.5 million malaria cases annually.
• Malaria risk in Pakistan is heterogeneous, with Punjab considered low-risk.
• International surveillance data from 2005-2012 is analyzed for imported malaria cases.

Purpose of the Study:

• To describe the trend of imported malaria cases originating from Pakistan.
• To identify changes in malaria incidence in travelers returning from Pakistan.

Main Methods:

• Utilized GeoSentinel and EuroTravNet networks to identify malaria cases acquired in Pakistan (2005-2012).
• Retrieved demographic and travel data, including specific destinations within Pakistan.
• Applied standard linear regression to analyze time trends.

Main Results:

• Identified 63 imported malaria cases acquired in Pakistan across six countries.
• Observed a statistically significant increasing trend in Plasmodium vivax malaria cases (p=0.006).
• This trend was particularly notable for cases acquired in the Punjab province.

Conclusions:

• The findings suggest a potential increase in malaria incidence in Pakistan's Punjab province.
• This contrasts with previous reports of decreasing malaria in the subcontinent and low-risk assessments for Punjab.
• Highlights the need for updated chemoprophylaxis guidelines and enhanced surveillance for imported malaria, including potential introduction into Europe.