Challenges in the diagnosis and treatment of malaria in Polish workers returning from Africa: a case series and review of literature

Abstract

Malaria is a parasitic disease caused in humans by five species of Plasmodium: P. falciparum, P. vivax, P. malariae, P. ovale, and P. knowlesi and transmitted through a female mosquito bite. In 2020, there were 241 million cases of malaria worldwide including 627,000 deaths. Traveling to malaria endemic areas is a significant risk factor, therefore, it is very important to use non-specific and pharmacological prophylaxis. Malaria symptoms usually appear 10–14 days after infection and the disease may be suspected, based on patient examination and medical history, in patients with fever who have stayed in malaria endemic areas. The initial symptoms of the disease are not pathognomonic and it is important to remember that not all malaria patients develop a fever. A prerequisite for successful treatment of this potentially life-threatening disease is well-targeted, timely diagnosis and immediate implementation of antiparasitic therapy. Despite significant progress in the fight against malaria across the world, the disease still poses a diagnostic and therapeutic challenge, especially when it develops as a result of an imported infection and when diagnosis is complicated by the presence of other diseases. A professional group that requires special attention are maritime workers. In this study we present clinical cases of malaria which show how important it is in the clinical practice of various specialists to include malaria in the differential diagnosis of patients with fever returning from tropical regions.