Imported malaria as a threat to Egypt

ABSTRACT

This work evaluated the clinical and parasitic status of malaria as a cause of fever among patients admitted to the Military fever hospitals. Thirty six patients were included twenty already diagnosed as malarial patients, who were recruited from Peace Keeping Mission Forces in Africa and sixteen cases presented with prolonged fever coming from different locations in Egypt. The results showed that El-Gabal El-Ahmar area [Cairo] was the most extensively infested region [37.4%]. This might be due to change of its ecolo-gical pattern since the year 2003 and the environmental conditions favoured by breeding and flaring mosquitoes. El-Sharkia and El-Fayoum Governorates [G.] were next in order [18.7%] and [12.5%] and this might be due to increased rural areas and agricultural projects and re-establishment. Plasmodium vivax was the main species among locally acquired patients [8 1.25%], while the imported patients coming back to Egypt from Africa especially [Sudan] had P. falciparum [100%]. However, P. falciparum was also present in 6.2% of cases from El Fayoum Governorate while P. ovale and P. malaria were not encountered. Of interest, was a case recruited from Ard-El- Golf, Heliopolis, an area with high social and hygienic standard, and the same condition applied to that from El-Nozha El-Gidida. Such cases included the [runway] or [airport] malaria, in which local transmission of disease has been attributed to an infected mosquito that was transported on a long haul flight. The two locally acquired cases were malaria positive by bone marrow smears and negative by peripheral blood examination. However, the thick blood film was the most sensitive [97.2%]. The patients [75%] were clinically and parasitologically cured, but one patient died. The best therapeutic response for locally acquired malaria infection was the monotherapy-based one such as Chloroquine or Mefloquine