Clinical and epidemiological profile of severe imported Plasmodium falciparum malaria in travelers at hospital admission: A retrospective single-center study in Moscow, Russia

Objectives: This study aimed to characterize the epidemiological patterns of imported severe malaria cases between 2020 and 2023 and investigate the most common serious clinical presentations observed at the time of hospital admission. Understanding these patterns would contribute to improved patient care and treatment protocols. Materials and Methods: This single-center, retrospective study analyzed the records of patients treated for severe imported malaria at Moscow’s Infectious Diseases State Hospital No. 2 between 2020 and 2023. Results: In total, 32 patients met the World Health Organization (WHO) criteria for severe malaria. The study group had a median age of 41 (interquartile range IQR: 36–52), was predominantly male (89%), and consisted mostly of individuals of Russian descent (91.2%). Nearly all acquired their infection in sub-Saharan African countries. No patient used malaria chemoprophylaxis before, during, or after visit to these countries. Patients typically sought medical attention a median of 5 days after their symptoms first appeared (IQR: 4–6). Plasmodium falciparum was the sole causative agent in every severe malaria case. A significant proportion of patients presented with high parasitemia and altered consciousness at the time of hospital admission (99% and 98%, respectively). The other prevalent indicators of severe malaria, as per the WHO guidelines, observed at admission were profound physical weakness (78.1%) and jaundice (52%). Conclusion: The findings emphasize the crucial role that antimalarial medication and prompt medical attention play in both preventing malaria and mitigating its severity. Prompt diagnosis and treatment of Plasmodium falciparum is crucial, as delays in identification can lead to more severe illness. Our investigation also highlights the necessity of improving pretravel consulting procedures.