Clinical and epidemiological profiles of confirmed malaria cases in the state of Pernambuco, Brazil, from 2001 to 2022.

BACKGROUND

Imported malaria is regularly detected in Pernambuco, a nonendemic area, highlighting the need for surveillance by healthcare professionals.

METHODS

We performed a descriptive observational study of malaria cases reported in Pernambuco during 2001-2022.

RESULTS

Most of the 350 patients were men (75.1%) and Mixed-race individuals (51.1%), with a median age of 32 years. Most patients resided in urban areas (81.1%), and 32% had primary education. Travel- and construction-related activities were the primary sources of exposure, with most infections originating in Brazil (52%) or Angola (33%). The median interval from symptom onset to testing was 10 days for Indigenous individuals, 5 days for Black individuals, and 4 days for Mixed race and White individuals. The delay was also longer for those with lower educational levels (6.5 days for primary education vs. 3 days for higher education). However, multivariate analysis showed that ethnicity, educational level, and geographic displacement were not statistically significant predictors of diagnostic delay. The cases showed a significant seasonal pattern, with a higher incidence during the first half of the year (p=0.0382). Although the annual incidence showed a slightly declining trend, this was not statistically significant (p=0.138). Plasmodium vivax and P. falciparum were the predominant species, accounting for 49.7% and 47.5% of cases, respectively.

CONCLUSIONS

Although disparities in median diagnostic times exist, multivariate analysis indicated that other complex factors are responsible for delayed diagnosis. Strengthening awareness among clinicians in nonendemic settings and ensuring timely testing are crucial for preventing severe outcomes and reducing malaria-related morbidity and mortality.