Naslov
Malaria in patients treated at University Hospital for Infectious Diseases in Zagreb, Croatia during the period from 2000 to 2018

Autori
Jeličić, Karlo ; Didović, Diana ; Dragobratović, Anja ; Baličević, Marina ; Begovac, Josip ; Lukas, Davorka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
2nd South-East European Conference on Travel, Tropical, Migration Medicine and HIV and the 3rd Croatian Conference on Travel, Tropical, Migration Medicine and HIV

Mjesto i datum
Dubrovnik, Hrvatska, 04.04.2019. - 07.04.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Malaria ; treatment

Sažetak
OBJECTIVE AND METHODS: A retrospective survey of patients hospitalised with malaria was conducted at the University Hospital for Infectious Diseases in Zagreb, Croatia (UHID), in the period from 2000 to 2018. We analysed the clinical, demographical and treatment profile and outcome of malaria. The data was collected from patients' clinical records. The diagnosis was confirmed by the presence of the parasites in the peripheral blood smear by microscopy. RESULTS: We treated 76 patients with malaria (67 male and 9 female), median age was 39 years (min. 2, max. 70 years). Majority of our patients (66, or 86.8%) acquired malaria in Sub- Saharan Africa. Considerable number of our patients (51 or 67.1 %) did not take any antimalarial chemoprophylaxis. The median time from symptom onset to the diagnosis was 5 days (IQR 3-8, min. 1, max. 45 days). Most infections were caused by P. falciparum (47 patients ; 61.8%), followed by P. vivax in 17 (22.3%), and 7 patients (9.72%) had mixed infection with both parasites. Fever was present in all 76 patients, the second most common symptom was headache, hepatosplenomegaly was found in 30 (39.4%) patients. Thrombocytopenia was noted in 61 patients (80.2%) ; with median platelet count of 75x109/microL (min. 4, max. 149, IQR 39-108). The median parasitemia on admittance was 0.8% (IQR 3-17.5, min. 0.1%, max 27%). Hyperparasitemia (>2%) was detected in 13 patients (18.06 %), all infected with P. falciparum. Seven patients developed severe complicated malaria and were admitted to the intensive care unit. Among 40 patients with uncomplicated falciparum malaria, 9 were treated with quinine-doxycycline (QD), 29 with artemether-lumefantrine (AL), 2 patients with mefloquine. Parasite clearance median was 3 days overall (all patients and all therapies), IQR 3-5, min. 2, max. 7 days. All patients survived. CONCLUSION: Malaria is eradicated in Croatia, and all cases are imported. Majority of our patients were long-term occupational travelers who did not take chemoprophylaxis. Patients with severe falciparum malaria were successfully treated with parenteral artesunate. In order to shorten the time from symptoms onset to malaria diagnosis, more education on the topic is needed for physicians and travellers to endemic areas.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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