Delay in diagnosis and treatment of patients with cases of imported malaria in Poland – one center’s experience

Abstract

Background . Increasingly, Polish citizens are traveling to malaria endemic regions; thus, physicians, especially primary care physicians, should be educated to recognize and treat malaria. Diagnosis and treatment of malaria encounters many difficulties in Poland. Objectives . The aim of the study was to analyze malaria chemoprophylaxis, the time from first symptoms to hospitalization and the process of diagnosis and treatment of patients with malaria. Material and methods . The medical records of patients diagnosed with malaria, hospitalized between 2012 and 2016 in the Department of Infectious Diseases of the University Hospital, Cracow, Poland, were analyzed. Results . 37 subjects with a median age of 32 years (interquartile range IQR: 28–40), mostly returning from Africa (78%, n = 29), were studied. Proper chemoprophylaxis was used in 6 cases (16%). The median length of stay in malaria endemic countries was one month. Plasmodium falciparum was the most frequent species (74%). The mean time to treatment after symptom onset was 5 days (range: 1–27 days). Conclusions . The clinical presentation of malaria in the study group was usually typical. Diagnostic delay resulted from not taking malaria into consideration during the initial differential diagnosis of fever. Few travelers use chemoprophylaxis, hence the awareness of malaria in individuals who have traveled to endemic zones should be enhanced. In a patient presenting with fever, malaria should always be considered in a differential diagnosis if there is a history of travel to a malaria-endemic zone.

Keywords

• chemoprophylaxis
• diagnosis
• malaria
• treatment
• <i>Plasmodium</i>