Epidemiological Patterns of Malaria Infection diagnosed at La Rabta Teaching Hospital in Tunisia

Abstract

Introduction: Since the last indigenous case in 1979, there has been no active transmission of malaria in Tunisia. However, imported malaria cases are increasing. Our study aimed to describe malaria cases detected in la Rabta Hospital from 2015 to 2018 and to assess adherence of Tunisian travelers to malaria prophylaxis. Methods: We conducted a descriptive and retrospective study of cases of malaria diagnosed in the laboratory of Parasitology and Mycology of La Rabta Hospital in Tunis during four years (2015 to 2018). Patients were addressed from several deparments of the same hospital as well as other public and private health facilities. Data were collected from patients’ information forms at the Laboratory which included demographic data, travel history, preventive measures taken and symptoms. Patients were tested by direct microscopic examination of thick and thin blood smears and rapid diagnostic tests. Results: A total of 339 patients consulted at the laboratory. Blood smears were positive among124patients (36.6% [31.9- 41.6]). Most of the cases were positive to Plasmodium falciparum (81.5%). The highest positivity rate was recorded in 2017 (p=0.003). Most positive cases were males (83%; p=0.001) and aged from 15 to 45 years (76.4%). More than half of positive cases were Tunisians (54%). All the cases travelled or were originated from sub-saharian countries except one transfusion-transmitted malaria Tunisian patient. Among Tunisian positive cases, pre-travel consultation, chemprophylaxis and personal protection were used in 25.7%, 22.7% and 42.4% of the cases respectively. Conclusions: In the absence of national data, our study provided an overview of the current malaria situation in Tunisia. Imported malaria cases are increasing and transfusion-transmitted malaria is still observed.With competent anopheles species still existing in the country, a strict surveillance is highly needed as well as regulations on blood donor screening and educationof travelers regarding malaria prophylaxis.