High imported malaria incidence at a Moroccon military hospital

Yıl 2014, , 44 - 49, 01.06.2014

Imane Tlamçani Najoua Benseddik Meryem Alami Moncef Amrani Salma Benjelloun Ghita Yahyaoui Mohammed Er-rami Mohammed Karim Moudden Mohamed El Baaj

https://doi.org/10.5799/ahinjs.02.2014.02.0125

Öz

Objective: To evaluate the importance of imported malaria at the Moulay Ismail Military Hospital of Meknes, we have led a descriptive study of the epidemiological, clinical, biological and evolutionary characteristics of the registered ma­laria cases. Methods: A prospective study was carried out at the Department of Parasitology from January 2011 to December 2012. In this study, we have included all the patients who were confirmed to have malaria through a biological diagnosis. Results: The number of the studied cases was 30; two in 2011 and 28 in 2012. The incidence has increased from 128.4 to 1798.3 per 100,000 travelers during this period among travelers. The average age was 31.3 ± 7.2 years (range 20 and 48 years). In all the cases, malaria was contracted in sub-Saharan Africa. Twenty six cases were in peacekeeping military mission; 15 of them have traveled and stayed in Ivory Coast and 11 in the Democratic Republic of Congo. The main clinical sign was fever Plasmodium falciparum was observed in 20 cases (66%), P. ovale in seven cases (24%), P. malariae in two cases (7%) and a combination of P. falciparum and P. ovale in one single case (3%). All patients received per oral mefloquine. The post therapeutic evolution was marked by a unique death from acute pulmonary edema, which was due to P. ovale. Conclusion: This high occurrence of malaria in our hospital is partially explained by the deployment of half of our mili­tary forces in various high risk fields.

Anahtar Kelimeler

Imported malaria, military, ivory coast, democratic republic of congo.

High imported malaria incidence at a Moroccon military hospital

Öz

Amaç: Meknes, Moulay İsmail Askeri Hastanesi’nde ithal sıtma olgularını değerlendirmek için, kayıtlı olguların epidemiyolojik, klinik, biyolojik ve gelişimsel özellikleri araştıran tanımlayıcı bir çalışma başlattık.Yöntemler: Bu çalışma prospektif olarak 01.01.2011 ile 31.12.2012 tarihleri arasında Parazitoloji Bölümü’nde gerçekleştirildi. Çalışmaya mikrobiyolojik olarak tanı konulan sıtma olgularını dahil ettik.Sonuçlar: Çalışmaya 2011 yılında iki ve 2012 yılında 28 olgu olmak üzere toplam 30 olgu dahil edildi. Seyahat için gidenlerde sıtma insidansı bu peryotta her 100.000 kişiye 128,4’den 1798,3’e yükseldi. Yaş ortalaması 31,3 ± 7,2 yıl idi (20-48 yıl arası). Sıtma olguları Sahra-altı Afrika kaynaklı idi. Yirmi altı olgu barış gücü askeri misyonunda çalışanlardan 15’i Fildişi Sahili’ne ve 11’i Kongo Demokratik Cumhuriyeti’ne görevli gitmişti. Hastalarda en sık klinik belirti ateş idi. Olguların 20’sinde Plasmodium falciparum (% 66), yedisinde P. ovale (% 24), ikisinde (% 7) P. malariae ve tek olguda (% 3) P. falciparum ve P. ovale bir arada görüldü. Tüm hastalar oral meflokin tedavisi aldı. Tedavi sonrası takiplerde P. ovale ile enfekte olan bir hasta akut akciğer ödemi nedeniyle öldü.Sonuçlar: Hastanemizde sıtma olgularının sık görülmesi askeri kuvvetlerimizin yarısının değişik yüksek riskli bölgelerde olması ile açıklanabilir

Anahtar Kelimeler

ithal sıtma, askeri, fildişi sahili, kongo demokratik cumhuriyeti

Kaynakça

• Muentener P, Schlagenhauf P, Steffen R. Imported malaria (1985-95): trends and perspectives. Bull World Health Organ 1999;77:560-566.
• Lopez Del Prado GR, Hernan Garcia C, Moreno Cea L, et al. Malaria in developing countries. J Infect Dev Ctries 2014;8:1- 4.
• Direction de l’épidémiologie et de lutte contre les maladies du ministère de la santé publique, Maroc. Rapport annuel d’activités; 2012.
• Charra B, Sodqi M, Sandali O, et al. Paludisme grave d’importation chez l’adulte: étude rétrospective de dix cas admis en réanimation à Casablanca. Med Mal Infect 2007;37:162-165.
• Rogier C, Henry MC, Trape JF. Evaluation épidémiologique du paludisme en zone d’endémie. Med Trop 2009;69:123-142.
• El Ouali L, Cherigui M, Koraichi SI, et al. Le paludisme importé dans le Centre Nord du Maroc entre 1997 et 2007. Cahiers d’études et de recherches francophones 2009;19:43-47.
• Mascarello M, Gobbi F, Angheben A, et al. Imported malaria in immigrants to Italy: a changing pattern observed in north eastern Italy. J Travel Med 2009;16:317-321.
• Odolini S, Gautret P, Parola P. Epidemiology of Imported Ma- laria in the Mediterranean Region. Mediterr J Hematol Infect Dis 2012;4:e2012031.
• Liu Y, S Hsiang M, Zhou H, et al. Malaria in overseas labour- ers returning to China: an analysis of imported malaria in Jiangsu Province, 2001–2011. Malaria Journal 2014;13:29.
• Migliani R, Ollivier L, Romand O et al. Paludisme chez les militaires français en Côte d’Ivoire de 1998 à 2006. Bull Epi- démiol Hebdo 2008;23-24:209-212.
• Lamblin A, Gerome P, Turc J, et al. Le paludisme d’importation à l’hôpital d’instruction des armées Desgenettes de Lyon en 2006-2008 : étude rétrospective de 115 cas. Med Sante Trop 2012;22:45-49.
• Belhadj S, Menif O, Kaouech E, et al. Le paludisme d’importation en Tunisie: bilan de 291 cas diagnostiqués à l’hôpital La Rabta de Tunis (1991-2006). Revue Franco- phone des Laboratoires 2008;399:95-98.
• El Wartiti MA, Lamsaouri J, Naoui H, et al. Profil épidémi- ologique et prophylactique du paludisme d’importation à l’hôpital militaire d’instruction Mohammed V de Rabat. Re- vue Internationale des Services de Santé des Forces Ar- mées 2012;85:43-48.
• Ajili F, Battikh R, Laabidi J, et al. Malaria in Tunisian military personnel after returning from external operation. Malaria Research and Treatment 2013: Article ID 359192.
• Bellanger AP, Faucher JF, Robedat P, et al. Malaria outbreak in French troops returning from Côte d’Ivoire. Scand J Infect Dis, 2011;43:230-233.