Nederlands tijdschrift voor geneeskunde · 1994
[Imported malaria: epidemiological, clinical and therapeutic data of 74 patients during 1 year in the Academic Medical Center, Amsterdam].
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Driessen S O, Wetsteyn J C
Аннотация
OBJECTIVE: To gain insight into the changes concerning diagnosis and treatment of malaria since 1984.
DESIGN: Retrospective.
SETTING: University Medical Centre, Amsterdam.
METHOD: From October 1991 to October 1992, 74 patients with malaria were diagnosed and treated. Country of origin, plasmodium strain involved, country of infection, interval between return to the Netherlands and onset of symptoms, prophylaxis and therapy, were recorded in every case.
RESULTS: Of these patients 46 (62%) were of European origin; 28 were born in endemic malarial areas. Plasmodium falciparum was diagnosed in 49 of the 74 patients; 88% of these infections were acquired in subsaharan Africa, mainly West Africa. In falciparum malaria, the first symptoms were noticed I-30 days after returning home. P. vivax infections occurred up to 2 years after return. Five of the 49 patients developed severe complications; 2 died. Twenty-six (53%) of the 49 patients had not taken any chemoprophylaxis. The patients with falciparum malaria were treated with sulfadoxine-pyrimethamine or halofantrine, often combined with quinine; the cure rate was 90%.
CONCLUSION: Quinine remains the mainstay in the treatment of complicated falciparum malaria, but is also often used in the initial treatment of uncomplicated malaria. Compliance in malaria prophylaxis still remains a problem.
DESIGN: Retrospective.
SETTING: University Medical Centre, Amsterdam.
METHOD: From October 1991 to October 1992, 74 patients with malaria were diagnosed and treated. Country of origin, plasmodium strain involved, country of infection, interval between return to the Netherlands and onset of symptoms, prophylaxis and therapy, were recorded in every case.
RESULTS: Of these patients 46 (62%) were of European origin; 28 were born in endemic malarial areas. Plasmodium falciparum was diagnosed in 49 of the 74 patients; 88% of these infections were acquired in subsaharan Africa, mainly West Africa. In falciparum malaria, the first symptoms were noticed I-30 days after returning home. P. vivax infections occurred up to 2 years after return. Five of the 49 patients developed severe complications; 2 died. Twenty-six (53%) of the 49 patients had not taken any chemoprophylaxis. The patients with falciparum malaria were treated with sulfadoxine-pyrimethamine or halofantrine, often combined with quinine; the cure rate was 90%.
CONCLUSION: Quinine remains the mainstay in the treatment of complicated falciparum malaria, but is also often used in the initial treatment of uncomplicated malaria. Compliance in malaria prophylaxis still remains a problem.