Low Frequency of Complications in Imported Falciparum Malaria: A Review of 222 Cases in South-eastern Norway

We performed a retrospective study of 222 cases of falciparum malaria diagnosed in Oslo and Akerhus counties, Norway, from January 1988 to December 1997. Except for 12 cases, all had acquired the disease in sub-Saharan Africa. Sixty-four (28.8%) cases occurred in assumed non-immune individuals; of t...

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Bibliographic Details
Published in:Scandinavian journal of infectious diseases 1999, Vol.31 (1), p.73-78
Main Author: Mogens Jensenius, Else Johanne Rønning, Hans Blystad, Arvid Bjørneklett, Kjell Block Hellum, Aira Bucher, Lise Lund Håheim, Bjørn Myrvang
Format: Article
Language:English
Subjects:
Adolescent
Adult
Africa South of the Sahara - epidemiology
Aged
Animals
Antimalarials - therapeutic use
Biological and medical sciences
Child
Child, Preschool
Chloroquine - therapeutic use
Female
Human protozoal diseases
Humans
Incidence
Infant
Infectious diseases
Longitudinal Studies
Malaria
Malaria, Falciparum - complications
Malaria, Falciparum - diagnosis
Malaria, Falciparum - epidemiology
Malaria, Falciparum - prevention & control
Male
Medical sciences
Middle Aged
Norway
Norway - epidemiology
Parasitic diseases
Plasmodium falciparum
Proguanil - therapeutic use
Protozoal diseases
Retrospective Studies
Risk Factors
Travel
Tropical medicine
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Summary:We performed a retrospective study of 222 cases of falciparum malaria diagnosed in Oslo and Akerhus counties, Norway, from January 1988 to December 1997. Except for 12 cases, all had acquired the disease in sub-Saharan Africa. Sixty-four (28.8%) cases occurred in assumed non-immune individuals; of these, 41 (64.1%) were compliant to recommended antimalarial chemoprophylaxis. The mean time lag from first symptom to diagnosis (total diagnosis delay) was 4.6 d (median 3 d, range 0-30 d) and the mean time from presentation to diagnosis (doctor's delay) was 1.3 d (median 0 d, range 0-25 d). There were no fatal cases, and only 8 (3.6%) had a complicated course. The following factors were significantly associated with development of complicated disease: higher age, non-immunity combined with chemoprophylaxis non-compliance, prolonged doctor's delay and prolonged total diagnosis delay (p < or = 0.05). Our data suggest that complicated disease in imported falciparum malaria may largely be prevented by high chemoprophylaxis compliance rates in non-immune travellers and a high index of suspicion in physicians evaluating febrile travellers.
ISSN:0036-5548
1651-1980
DOI:10.1080/00365549950161925