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Issue Date
2016-06-02
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Malaria in Iceland, a rare but looming threat for travelersCitation
Malaría á Íslandi, sjaldgæf en stöðug ógn fyrir ferðalanga 2016, 2016 (06):271-276 LæknablaðiðAbstract
Inngangur: Malaría er sníkjudýrasýking og ein algengasta orsök ótímabærra dauðsfalla í þróunarlöndum, einkum meðal barna. Sjúkdómurinn greinist af og til á Íslandi í einstaklingum sem hafa dvalist á malaríusvæð- um. Í rannsókn sem gerð var á sjúkdómnum hérlendis 1980-1997 fundust 15 staðfest tilfelli. Tilgangur þessarar afturskyggnu rannsóknar var að rannsaka faraldsfræði malaríu 1998-2014 á Íslandi. Efniviður og aðferðir: Sjúkragögn þeirra sem greindust með malaríu hér á landi samkvæmt blóðstroki eða blóðdropa voru yfirfarin. Einnig var aflað gagna um sölu malaríulyfja og um utanlandsferðir Íslendinga á tímabilinu. Niðurstöður: Staðfestar malaríusýkingar reyndust vera 31. Í heild voru að meðaltali 1,8 tilfelli á ári, greiningartíðni um 0,6 tilfelli/100 þúsund íbúa/ ári. Á tímabilinu 1980-1997 var greiningartíðni 0,3/100 þúsund/ári. Ekki reyndist marktækur munur á tíðni milli tímabila (p=0,056). Plasmodium falciparum greindist í 71% tilfella, P. vivax í 16%, P. ovale og P. malariae hvor um sig í 7%. Einungis tveir sjúklingar (7%) höfðu tekið fyrirbyggjandi lyf. Einn sjúklingur fékk sýkingarbakslag. Tveir lögðust inn á gjörgæslu en enginn lést. Algengasta lyfjameðferð var atóvakón með prógúaníl. Sala þess sem fyrirbyggjandi lyfs stóð í stað árin 2010-2014 en á sama tíma varð aukning í utanlandsferðum Íslendinga. Ályktun: Á Íslandi hefur greiningum á malaríu fjölgað lítillega en á sama tímabili hefur tilfellum í nágrannaríkjunum fækkað. Fylgjast þarf með tíðni sjúkdómsins og afdrifum sjúklinga á Íslandi næstu ár. Mikilvægt er að efla forvarnir meðal ferðamanna á malaríusvæðum, þar með talið töku fyrirbyggjandi lyfjaIntroduction: Malaria is one of the most common causes of preventable deaths in the developing countries, especially among children. A previous study of imported malaria in Iceland during 1980-1997 identified 15 confirmed cases. The objective of this retrospective study was to update epidemiological data on malaria in Iceland, 1998-2014. Materials and methods: The inclusion criteria were a positive thick or thin blood smear for malaria parasites at the Dept. of Microbiology at Landspitali University Hospital, which serves as a referral laboratory for malaria diagnosis in the country. Medical records of confirmed cases, nationwide sales data for antimalarial agents and international travel of Icelanders were reviewed. Results: Thirty-one cases of malaria were confirmed in Iceland during 1998-2014, 1.8 cases/year on average, a rate of 0.6 cases/100.000 inhabitants/year. The rate was 0.3/100.000 inhabitants/year in the previous study 1980-1997 (p=0.056). Plasmodium falciparum was identified in 71% of cases, P. vivax in 16%, P. ovale and P. malariae in 7% each. Only 2 patients (7%) had used chemoprophylaxis prior to diagnosis. Two patients needed intensive care, but no fatalities were documented. One patient had a relapse. The most common agent used for treatment was atovaquone with proguanil, however annual sales figures plateaued during 2010-2014 despite a significant increase in foreign travel by Icelanders during the same period. Conclusion: The detection rate for malaria in Iceland showed a tendency for increase between study periods while a slight decrease was noted in the neighbouring countries at the same time. The importance of antimalarial chemoprophylaxis and other preventive measures among Icelandic travellers to endemic areas needs to be emphasized.
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http://www.laeknabladid.is/tolublod/2016/06/nr/5915Rights
Archived with thanks to Læknablaðiðae974a485f413a2113503eed53cd6c53
10.17992/lbl.2016.06.84
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