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<p>In Tunisia, malaria has been eliminated since 1979. However, local transmission remains a risk because of the coexistence of <i>Anopheles</i> mosquito vectors and the increasing number of imported cases. Our study aimed to update the epidemiological profile of imported malaria cases in Tunisia and to assess the compliance of malaria prophylaxis among Tunisian travelers. A retrospective study was performed including imported malaria cases diagnosed at Pasteur Institute of Tunis between 2008 and 2022. Diagnosis of malaria was based on microscopic examination of blood smears. A total of 270 imported malaria cases were diagnosed. The incidence showed a gradually increasing trend from 5 (in 2008) to 56 cases (in 2022). Tunisian travelers accounted for 30% of cases. One hundred twenty-seven individuals (47%) were asymptomatic immigrants, corresponding to students. The main countries of infection were in sub-Saharan Africa particularly the Ivory Coast (25.9%) and the Democratic Republic of Congo (24.1%). <i>Plasmodium falciparum</i> was the dominant species (88.5%). Clinically, fever was the most frequent symptom (93%). The median interval between symptom onset and laboratory diagnosis was 4&#xa0;days (IQR: 2–7). Only 23.5% of Tunisian travelers reported taking adequate chemoprophylaxis. Protection against mosquito bites was used in 47.1% of cases. In view of the increasing number of imported malaria cases, it is necessary to strengthen the surveillance strategy for individuals at risk of infection and <i>Anopheles</i> mosquitoes. Preventive measures should also be promoted among travelers to endemic areas, given the poor compliance with chemoprophylaxis.</p>

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Update of epidemiological profile of imported malaria cases in Tunisia for a better management and control of the disease elimination

  • 期刊论文

  • 发表日期：

    2025年9月5日

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  • Emna Siala,
  • Wafa Aissi,
  • Nada Boulehmi,
  • Aida Bouratbine,
  • Karim Aoun

摘要

In Tunisia, malaria has been eliminated since 1979. However, local transmission remains a risk because of the coexistence of Anopheles mosquito vectors and the increasing number of imported cases. Our study aimed to update the epidemiological profile of imported malaria cases in Tunisia and to assess the compliance of malaria prophylaxis among Tunisian travelers. A retrospective study was performed including imported malaria cases diagnosed at Pasteur Institute of Tunis between 2008 and 2022. Diagnosis of malaria was based on microscopic examination of blood smears. A total of 270 imported malaria cases were diagnosed. The incidence showed a gradually increasing trend from 5 (in 2008) to 56 cases (in 2022). Tunisian travelers accounted for 30% of cases. One hundred twenty-seven individuals (47%) were asymptomatic immigrants, corresponding to students. The main countries of infection were in sub-Saharan Africa particularly the Ivory Coast (25.9%) and the Democratic Republic of Congo (24.1%). Plasmodium falciparum was the dominant species (88.5%). Clinically, fever was the most frequent symptom (93%). The median interval between symptom onset and laboratory diagnosis was 4 days (IQR: 2–7). Only 23.5% of Tunisian travelers reported taking adequate chemoprophylaxis. Protection against mosquito bites was used in 47.1% of cases. In view of the increasing number of imported malaria cases, it is necessary to strengthen the surveillance strategy for individuals at risk of infection and Anopheles mosquitoes. Preventive measures should also be promoted among travelers to endemic areas, given the poor compliance with chemoprophylaxis.