Imported malaria cases: the connection with the European ex-colonies

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Imported malaria incidence is rising in non-endemic regions due to increased international travel and migration.
• Understanding the characteristics of these cases is vital for effective public health interventions.

Purpose of the Study:

• To describe the epidemiology and clinical features of malaria cases in Aragon, Spain (1996-2017).
• To analyze associations between malaria case variables.
• To compare malaria cases by country of origin, focusing on Equatorial Guinea and other sub-Saharan African countries.

Main Methods:

• A retrospective observational study analyzed reported malaria cases in Aragon from 1996 to 2017.
• Univariate and bivariate analyses were performed on clinical-epidemiological variables.
• Logistic regression was used to analyze cases from sub-Saharan Africa, calculating odds ratios and 95% confidence intervals.

Main Results:

• 609 malaria cases were recorded; Plasmodium falciparum was the predominant species (88%).
• Most cases (82.6%) resided in urban areas, with Visiting Friends and Relatives (VFR) being the largest group (65.4%).
• Cases from Equatorial Guinea showed associations with female gender, age under 5, urban residence, and new immigrant status.

Conclusions:

• The typical imported malaria case in Aragon is a VFR individual aged 15-39 from sub-Saharan Africa, particularly Equatorial Guinea.
• Educational initiatives on chemoprophylaxis are needed for immigrants and VFR travelers, especially those from former colonies.
• Healthcare professionals should be vigilant in advising patients on malaria prevention before travel.