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Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting

In this study, we reviewed imported malaria cases observed at the National Center for Global Health and Medicine, Tokyo, between 2005 and 2016, to comprehend their demographic and clinical characteristics. Data on 169 cases were used to analyze demographic information; data on 146 cases were used fo...

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Autores principales: Takaya, Saho, Kato, Yasuyuki, Katanami, Yuichi, Yamamoto, Kei, Kutsuna, Satoshi, Takeshita, Nozomi, Hayakawa, Kayoko, Kanagawa, Shuzo, Komaki-Yasuda, Kanako, Kano, Shigeyuki, Ohmagari, Norio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447110/
https://www.ncbi.nlm.nih.gov/pubmed/30675850
http://dx.doi.org/10.4269/ajtmh.18-0722
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author Takaya, Saho
Kato, Yasuyuki
Katanami, Yuichi
Yamamoto, Kei
Kutsuna, Satoshi
Takeshita, Nozomi
Hayakawa, Kayoko
Kanagawa, Shuzo
Komaki-Yasuda, Kanako
Kano, Shigeyuki
Ohmagari, Norio
author_facet Takaya, Saho
Kato, Yasuyuki
Katanami, Yuichi
Yamamoto, Kei
Kutsuna, Satoshi
Takeshita, Nozomi
Hayakawa, Kayoko
Kanagawa, Shuzo
Komaki-Yasuda, Kanako
Kano, Shigeyuki
Ohmagari, Norio
author_sort Takaya, Saho
collection PubMed
description In this study, we reviewed imported malaria cases observed at the National Center for Global Health and Medicine, Tokyo, between 2005 and 2016, to comprehend their demographic and clinical characteristics. Data on 169 cases were used to analyze demographic information; data on 146 cases were used for the analysis of clinical information. The median patients’ age was 34 years, and 79.3% of them were male. The proportion of non-Japanese patients increased and surpassed that of Japanese patients after 2015. In 82.2% of the cases, the region of acquisition was Africa, and Plasmodium falciparum was the dominant species (74.0%) followed by Plasmodium vivax (15.4%). We observed 19 (18.4%, 19/103) severe falciparum malaria cases. Mefloquine was the most commonly used drug for treatment until the early 2010s; atovaquone/proguanil was the most commonly used after its licensure in 2013. Although none of the patients died, four recrudescence episodes after artemether/lumefantrine (A/L) treatment and one relapse episode were observed. Overall, malaria was diagnosed on median day 4 of illness, and, thereon, treatment was initiated without delay. Diagnosis on day 5 or later was significantly associated with severe disease in Japanese cases (odds ratio = 4.1; 95% CI = 1.2–14.3). We observed a dominance of falciparum malaria, an increase in the number of non-Japanese cases, late treatment failure after A/L treatment, a low relapse rate, and an association between delayed malaria diagnosis and higher disease severity. Pretravel care and early diagnosis are necessary to reduce malaria-related mortality and morbidity in settings such as ours.
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spelling pubmed-64471102019-04-09 Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting Takaya, Saho Kato, Yasuyuki Katanami, Yuichi Yamamoto, Kei Kutsuna, Satoshi Takeshita, Nozomi Hayakawa, Kayoko Kanagawa, Shuzo Komaki-Yasuda, Kanako Kano, Shigeyuki Ohmagari, Norio Am J Trop Med Hyg Articles In this study, we reviewed imported malaria cases observed at the National Center for Global Health and Medicine, Tokyo, between 2005 and 2016, to comprehend their demographic and clinical characteristics. Data on 169 cases were used to analyze demographic information; data on 146 cases were used for the analysis of clinical information. The median patients’ age was 34 years, and 79.3% of them were male. The proportion of non-Japanese patients increased and surpassed that of Japanese patients after 2015. In 82.2% of the cases, the region of acquisition was Africa, and Plasmodium falciparum was the dominant species (74.0%) followed by Plasmodium vivax (15.4%). We observed 19 (18.4%, 19/103) severe falciparum malaria cases. Mefloquine was the most commonly used drug for treatment until the early 2010s; atovaquone/proguanil was the most commonly used after its licensure in 2013. Although none of the patients died, four recrudescence episodes after artemether/lumefantrine (A/L) treatment and one relapse episode were observed. Overall, malaria was diagnosed on median day 4 of illness, and, thereon, treatment was initiated without delay. Diagnosis on day 5 or later was significantly associated with severe disease in Japanese cases (odds ratio = 4.1; 95% CI = 1.2–14.3). We observed a dominance of falciparum malaria, an increase in the number of non-Japanese cases, late treatment failure after A/L treatment, a low relapse rate, and an association between delayed malaria diagnosis and higher disease severity. Pretravel care and early diagnosis are necessary to reduce malaria-related mortality and morbidity in settings such as ours. The American Society of Tropical Medicine and Hygiene 2019-04 2019-01-21 /pmc/articles/PMC6447110/ /pubmed/30675850 http://dx.doi.org/10.4269/ajtmh.18-0722 Text en © The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Takaya, Saho
Kato, Yasuyuki
Katanami, Yuichi
Yamamoto, Kei
Kutsuna, Satoshi
Takeshita, Nozomi
Hayakawa, Kayoko
Kanagawa, Shuzo
Komaki-Yasuda, Kanako
Kano, Shigeyuki
Ohmagari, Norio
Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting
title Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting
title_full Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting
title_fullStr Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting
title_full_unstemmed Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting
title_short Imported Malaria at a Referral Hospital in Tokyo from 2005 to 2016: Clinical Experience and Challenges in a Non-Endemic Setting
title_sort imported malaria at a referral hospital in tokyo from 2005 to 2016: clinical experience and challenges in a non-endemic setting
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447110/
https://www.ncbi.nlm.nih.gov/pubmed/30675850
http://dx.doi.org/10.4269/ajtmh.18-0722
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