Imported malaria: 54 cases diagnosed at the Ibn Sina Hospital Center in Rabat, Morocco

Abstract

Morocco does not record any indigenous malaria case since 2004 and is certified by the World Health Organization as malaria-free since 2010. However, the country continues to record a significant number of imported malaria cases from endemic areas, especially from West Africa. The purpose of our work is to determine the epidemiological and diagnostic characteristics of malaria cases diagnosed at Ibn Sina Hospital Center in Rabat, Morocco. This work is a retrospective study of a series of malaria cases diagnosed between January 2012 and December 2016 at the Central Laboratory of Parasitology and Mycology of Ibn Sina Hospital Center. The methods used for the parasitological diagnosis are the search for the parasite at direct examination on thin blood film and thick drop and the search for parasite antigens by a rapid diagnostic immunochromatographic test (OptiMAL-IT® kit). Of 192 patients in whom malaria was sought, we recorded 54 positive cases (average of 10.8 cases per year). The prevalence was 28.12%. The age ranged from 4 to 76 years (average of 29.5 years). The sex ratio was 2.6. All cases had in their antecedents a notion of recent travel in an endemic area. The most common travel area was West Africa: Ivory Coast, with 31.43% of cases, followed by Guinea, with 14.29% of cases. The symptomatology was dominated by fever in 52 patients (96.3% of cases), followed by headache in 22 cases (40.74%). Anemia was present in 7 and thrombocytopenia in 12 patients. The most isolated species was Plasmodium falciparum (84.21% of cases), followed by P. vivax (10.53% of cases) and P. ovale (5.26% of cases). One case involved two species: P. falciparum and P. vivax. Parasitaemia was between less than 0.1 and 20%. Despite the local eradication of malaria, the persistence of imported cases, mainly due to the lack of chemoprophylaxis, should call for the strengthening of health education of travelers, especially in endemic areas.

Keywords: Imported malaria; Morocco; Plasmodium falciparum.