IMPORTED MALARIA IN LISBON

Imported malaria is increasing in Western countries, leading to a high mortality rate among severe cases, mainly due to delayed diagnosis an d treatment. The authors carried out a 7 years retrospective study (19 89-1995) on 205 patients diagnosed with malaria, in the Department of Infectious Diseases, in the Lisbon S. Maria Hospital,. The annual rate was 30 cases per year. Of these patients, 146 (71%) were male, 107 (5 2%) were black, 121 (59%) lived in endemic malaria areas. The origin o f infection was mainly western Africa, Angola being the country with t he most cases (47%). Plasmodium falciparum accounted for 93% of the to tal infections, followed by P. vivax (5%), P. malariae (1%) and P. ova le (0.5%). In 9 patients mixed infections were found (P. falciparum/P. vivax, 6 cases; P. falciparum/P. malariae, 2 cases; P. malariae/P. vi vax, 1 case). Only 45 patients (22%) had received malarial prophylaxis . Thrombopenia was the most frequent biological sign (present in 70% o f the cases), followed to a lesser degree by LDH elevation, anemia, an d liver dysfunction. Nineteen patients (9%) developed severe malaria c omplications (10 cerebral malaria, 10 renal failure, 2 pulmonary distr ess, and 2 splenic infarcts). Severe malaria was more frequent in whit e patients and in those living outside endemic areas. Prior chemoproph ylaxis was equally frequent between both groups. Six patients died, th e risk of dead being higher among those with multiple organ failure.