AI Article Synopsis
- Bulgaria was declared malaria-free in 1965, but over a 21-year study period (2000-2020), 232 cases of imported malaria were recorded, mostly among Bulgarian citizens working in Africa.
- Of the total cases, 63.4% were Bulgarian citizens, with the majority infected by P. falciparum, while foreign nationals mostly had P. vivax infections.
- Clinical complications occurred in 14.7% of cases, and a fatal outcome was noted in 3.5%, indicating the need for better diagnosis, management, and preventive measures in the country.
Article Abstract
Background: Bulgaria, with a high endemicity for malaria in the past, was declared by the WHO as a malaria-free country in 1965. We intended to analyze the epidemiological and clinical implications of imported malaria cases in Bulgaria.
Methods: This is a retrospective cross-sectional analysis of all recorded cases of imported malaria in Bulgaria over a 21-year period (2000-2020). Patients' clinical records and information gathered from the epidemiological survey of each recorded malaria case were reviewed.
Results: A total of 232 cases of imported malaria were reported, 147 (63.4%) were Bulgarian citizens (BC) and 85 (36.6%) were foreign nationals (FN). Two thirds (66.4%) of cases were diagnosed from April to October. Most BCs had travelled for work (66.6%) to Africa (93.9%) and were infected with P. falciparum (83.3%), while most FNs were migrants (54.7%), exposed in Asia (63.5%) with P. vivax infection (62.4%). Clinical complications and a fatal outcome were noted in 14.7% (n = 34) and 3.5% (n = 8) of cases respectively. All complicated cases were in BNs with P. falciparum infection.
Conclusions: Bulgaria experiences a steady import of malaria. Efforts to improve diagnosis, management and prevention of malaria, as well as maintenance of a high degree of epidemiological vigilance are needed.
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| http://dx.doi.org/10.1016/j.tmaid.2022.102400 | DOI Listing |
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