Imported malaria in Lombardia. A second review of hospitalized cases in 1981-1985.

We carried out a research on hospitalized cases of imported malaria in Lobardy in the period 1981-1985 to characterize the risk factors and the clinical features of this phenomenon and to identify its trend in comparison with the previous quinquennium (Carosi et al., 1983) 1) Prevalent factors of risk are: the P falciparum etiology (68%), the african origin of the strains, the work motivated travelling (56%) and a long period of stay (56%) in the summer-autumnal season (62%). On the contrary, in the previous quinquennium, short periods of stay during winter season prevailed. 2) As far as the chemoprophylaxis is concerned, it has been adopted in 55% of the cases, but only in 14 cases it was correct. In 52% of the cases, symptoms were noted within 20 days of re-entry, and in 17% of the cases they started abroad. In 62% of the cases a correct diagnosis was made within 10 days from the onset of symptoms and in 72% fever disappeared within 48 hours after therapy. Data show an inversion of the trend of the previous quinquennium and evidentiate a wider use of chemoprophylaxis and a more effective therapeutic action by the Sanitary Structure in Lombardy. The Authors stress the need for improvement in malaria control programs by Italian industries working in Developing Countries (roads and dams construction) and the increasing prophylactic problems related to the widespread extent of chloroquine resistant P. falciparum strains in Africa. Our causistry shows the outcome of 14 falciparum malaria cases in spite of correct chloroquine chemoprophylaxis.