Trends in imported malaria during the COVID-19 pandemic, Spain (+Redivi Collaborative Network)

Area of Science:

• Epidemiology
• Infectious Diseases
• Global Health

Background:

• The COVID-19 pandemic disrupted global malaria prevention and management.
• Data on travel-related malaria infections during the pandemic are limited.
• Understanding trends in imported malaria is crucial for public health.

Purpose of the Study:

• To analyze epidemiological and clinical characteristics of imported malaria cases in Spain.
• To identify yearly trends in imported malaria from pre-pandemic to current years.
• To assess the impact of the COVID-19 pandemic on malaria case numbers and severity.

Main Methods:

• Retrospective analysis of malaria cases recorded in the +Redivi network (October 2009–December 2021).
• Inclusion of patients diagnosed with malaria using standard diagnostic methods.
• Analysis of total cases, patient types, and severe malaria cases per year.

Main Results:

• 1751 malaria cases identified (6.6% of total), predominantly in males and visiting friends and relatives (VFR)-immigrants.
• Most infections acquired in sub-Saharan Africa, primarily Plasmodium falciparum.
• A significant increase in severe malaria cases observed, particularly in 2021 (17.2%), mainly in travelers and VFR-immigrants.

Conclusions:

• Imported malaria cases and severe malaria incidence rose following COVID-19 travel restrictions.
• Late presentation and diagnosis of imported malaria may occur during public health crises.
• Healthcare professionals need heightened awareness of the recent surge in severe imported malaria cases.