Abstract
Malaria is one of the ‘big three’ killer infectious diseases, alongside tuberculosis and HIV. In non-endemic areas, malaria may occur in travelers who have recently been to or visited endemic regions. The number of imported malaria cases in Portugal has increased in recent years, mostly due to the close relationship with the community of Portuguese language countries. Samples were collected from malaria-infected patients attending Centro Hospitalar Lisboa Ocidental (CHLO) or the outpatient clinic of Instituto de Higiene e Medicina Tropical (IHMT-NOVA) between March 2014 and May 2021. Molecular characterization of Plasmodium falciparum pfk13 and pfmdr1 genes was performed. We analyzed 232 imported malaria cases. The majority (68.53%) of the patients came from Angola and only three patients travelled to a non-African country; one to Brazil and two to Indonesia. P. falciparum was diagnosed in 81.47% of the cases, P. malariae in 7.33%, P. ovale 6.47% and 1.72% carried P. vivax. No mutations were detected in pfk13. Regarding pfmdr1, the wild-type haplotype (N86/Y184/D1246) was also the most prevalent (64.71%) and N86/184F/D1246 was detected in 26.47% of the cases. The typical imported malaria case was middle-aged male, traveling from Angola, infected with P. falciparum carrying wild type pfmdr1 and pfk13. Our study highlights the need for constant surveillance of malaria parasites imported into Portugal as an important pillar of public health.
Highlights
Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Centro Hospitalar Lisboa Ocidental (CHLO), Rua da Junqueira 126, 1349-019 Lisboa, Portugal; Academic Editor: Adriana Calderaro
Our study analysed the imported malaria cases diagnosed with malaria at IHMT and CHLO laboratories from March 2014 to May 2021
We found a dominance of P. falciparum in 81.47% of the cases from Africa, including five mixed infections (Table 1) as compared with those originating from other regions (Brazil 0.46% and Indonesia 0.92%)
Summary
Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Centro Hospitalar Lisboa Ocidental (CHLO), Rua da Junqueira 126, 1349-019 Lisboa, Portugal; Academic Editor: Adriana Calderaro. The number of imported malaria cases in Portugal has increased in recent years, mostly due to the close relationship with the community of Portuguese language countries. Molecular characterization of Plasmodium falciparum pfk and pfmdr genes was performed. P. falciparum was diagnosed in 81.47% of the cases, P. malariae in 7.33%, P. ovale 6.47%. The wild-type haplotype (N86/Y184/D1246) was the most prevalent (64.71%) and N86/184F/D1246 was detected in 26.47% of the cases. The typical imported malaria case was middle-aged male, traveling from Angola, infected with P. falciparum carrying wild type pfmdr and pfk. There are 5 species of malaria parasites that cause disease in humans: Plasmodium falciparum, P. ovale, P. vivax, P. malariae [1] and P. knowlesi [2]. More than 95% of cases and malaria-related deaths were caused by P. falciparum [3]. Once prevalent in almost every country in Europe, malaria transmission began to decline from the early 20th century and by 1975 Europe was declared free of endemic malaria transmission, with the exception of few restricted outbreaks related to the First and Second World
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