Imported malaria in children: A 13 years retrospective study

Area of Science:

• Tropical medicine
• Pediatric infectious diseases
• Public health

Background:

• Malaria is not endemic in Italy, but imported cases, often in children visiting friends and relatives (VFRs), pose a public health concern.
• VFR travelers, particularly children, are at higher risk for severe malaria due to socioeconomic factors and poor awareness of prophylaxis.

Purpose of the Study:

• To analyze the characteristics of pediatric imported malaria cases.
• To identify prevention strategies and risk factors for severe malaria in children.
• To evaluate diagnostic accuracy and treatment efficacy.

Main Methods:

• Retrospective observational study of pediatric malaria cases diagnosed between 2007-2019.
• Data collection included epidemiological and clinical information.
• Analysis of chemoprophylaxis use, parasitemia levels, and treatment outcomes.

Main Results:

• 72 pediatric cases were identified, predominantly VFRs from Africa with Plasmodium falciparum infection.
• Only 33.3% received chemoprophylaxis, and none appropriately; incomplete prophylaxis did not significantly impact severity.
• High parasitemia correlated with severe anemia and thrombocytopenia; 25% of initial diagnoses were incorrect. Artemisinin derivatives shortened parasite clearance time.

Conclusions:

• Pediatric imported malaria in Italy, especially among VFRs, requires improved prophylaxis awareness and education.
• Clinicians must consider malaria in febrile patients with travel history to endemic regions.
• Prompt diagnosis and guideline-adherent treatment, including artemisinin derivatives, are crucial for better patient outcomes.