Comparing imported malaria in adults and children presenting to an Italian teaching hospital: A 10-year retrospective study.

Abstract

Malaria is not endemic in Italy, but it still represents an important threat to the travelers' health. With this study we wanted to compare the characteristics of imported malaria between adults and children. This retrospective observational study includes all patients admitted to the Infectious Diseases Unit and in the Pediatric Department of Padua (Italy), and discharged with a diagnosis of malaria from 2005 to 2015. The variables considered are epidemiological and clinical. 172 cases of imported malaria were studied (124 adults and 48 children), P.falciparum was responsible for 90,7% of the cases, and was contracted mostly in Africa (96,5%), especially by foreigners visiting friends and relatives (VFR). Chemoprophylaxis was adopted only by few patients. 93% of all the patients developed the uncomplicated malaria, but pediatric patients had severe malaria significantly more often than adults (OR=4,06, p=0,015). Children also had significantly lower hemoglobin levels and higher parasitemia. The drugs used to treat the two groups were substantially different, but both had a good overall outcome. In order to reduce the risk of imported malaria, educational actions should target potential VFR travelers, and they should underline the different risk of severe malaria in adults and children. A further implementation of the recommended therapies could improve the patients' outcome.