Volume 25, Number 2—February 2019
Dispatch
Submicroscopic Malaria in Migrants from Sub-Saharan Africa, Spain
Joaquín Pousibet-Puerto, Mª Teresa Cabezas-Fernández, Ana B. Lozano-Serrano, José Vázquez-Villegas, Manuel J. Soriano-Pérez, Isabel Cabeza-Barrera, José A. Cuenca-Gómez, and Joaquín Salas-Coronas
Table 1
Epidemiologic characteristics and findings of laboratory blood tests of patients in a study of SMM in migrants from sub-Saharan Africa to Spain, October 2004–December 2016
| Characteristic | All, N = 370 | Non-SMM, n = 337 | SMM, n = 33 | p value |
|---|---|---|---|---|
| Age, y, median (IQR) |
28 (13) |
28 (12) |
27 (14) |
0.78 |
| Sex, no. (%) | ||||
| M | 309 (83.5) | 283 (84.0) | 26 (78.8) | 0.44 |
| F |
61 (16.5) |
54 (16.0) |
7 (21.2) |
|
| Country of origin, no. (%) | ||||
| Senegal | 102 (27.6) | 98 (29.1) | 4 (12.1) | |
| Guinea Bissau | 69 (18.6) | 64 (19.0) | 5 (15.2) | |
| Mali | 61(16.5) | 53 (15.7) | 8 (24.2) | |
| Mauritania | 28 (7.6) | 28 (8.3) | 0 | |
| Equatorial Guinea | 23 (6.2) | 16 (4.8) | 7 (21.2) | |
| Gambia | 20 (5.4) | 19 (5.6) | 1 (3.0) | |
| Burkina-Faso | 18 (4.9) | 14 (4.2) | 4 (12.1) | |
| Ghana | 18 (4.9) | 16 (4.8) | 2 (6.1) | |
| Guinea-Conakry | 16 (4.3) | 16 (4.8) | 0 | |
| Nigeria | 7 (1.9) | 6 (1.8) | 1 (3.0) | |
| Ivory Coast | 5 (1.4) | 4 (1.2) | 1 (3.0) | |
| Cameroon | 1 (0.3) | 1 (0.3) | 0 | |
| Gabon | 1 (0.3) | 1 (0.3) | 0 | |
| Democratic Republic of the Congo |
1 (0.3) |
1 (0.3) |
0 |
|
| Type of traveler, no. (%) | ||||
| NAM, <1 y of stay | 244 (65.9) | 222 (65.9) | 22 (66.7) | |
| VFR, returned <1 y |
126 (34.1) |
115 (34.1) |
11 (33.3) |
0.93 |
| Referring hospital department, no. (%) | ||||
| Primary care | 279 (75.4) | 255 (75.7) | 24 (72.7) | |
| Emergency | 27 (7.3) | 23 (6.8) | 4 (12.1) | |
| Internal medicine | 17 (4.6) | 16 (4.7) | 1 (3.0) | |
| Other |
47 (12.7) |
43 (12.8) |
4 (12.2) |
|
| Main reason for referral, no. (%) | ||||
| Abdominal pain | 107 (28.9) | 102 (30.3) | 5 (15.2) | |
| Viral hepatitis or liver test abnormalities | 80 (21.6) | 72 (21.4) | 8 (24.2) | |
| Eosinophilia | 53 (14.3) | 43 (12.8) | 10 (30.3) | |
| Pruritus or skin disorders | 21 (5.7) | 19 (5.6) | 2 (6.1) | |
| Hematuria |
9 (2.4) |
9 (2.7) |
0 |
|
| Median time to SMM screening since travel, mo. (IQR) | ||||
| Total | 5 (5) | 5 (5) | 3 (4) | 0,03 |
| Newly arrived | 6 (5) | 5.5 (5) | 6 (5) | 0,66 |
| VFR |
4 (7) |
4 (8) |
2 (3) |
<0.01 |
| Malaria prophylaxis in VFRs, no. (%), n = 126 | ||||
| No | 59 (51.3) | 5 (45.4) | 0.79 | |
| Inadequate | 7 (6.1) | 1 (9.1) | ||
| Yes | 32 (27.8) | 4 (36.4) | ||
| Unknown† |
17 (14.8) |
1 (9.1) |
||
| Baseline laboratory data, median (IQR)‡ | ||||
| Hb, g/dL | 14.85 (2.1) | 14.9 (2.1) | 14.6 (2) | 0.22 |
| Platelets, × 103/μL | 233.5 (83) | 233 (83) | 247 (71) | 0.72 |
| Total eosinophils/μL | 280 (481) | 270 (440) | 440 (614) | 0.12 |
| Total bilirubin, mg/dL | 0.66 (0.47) | 0.62 (0.53) | 0.72 (0.36) | 0.71 |
| Alanine aminotransferase, U/L | 20 (17) | 20 (17) | 27 (7) | 0.79 |
| Aspartate aminotransferase, U/L | 27 (11) | 27 (12) | 20 (12.5) | 0.80 |
| IgE, U/mL | 299.46 (1033) | 284.86 (986.31) | 484 (923.83) | 0.14 |
| Structural hemoglobinopathies study, no. (%), n = 367 patients | 85 | 71/334 (21.3) | 14/33 (42.4) | 0.01 |
| Heterozygous Hb S | 40 | 7 | ||
| Heterozygous Hb C | 12 | 2 | ||
| Homozygous Hb C | 1 | 3 | ||
| Thalassemia trait or α-thalassemia | 13 | 1 | ||
| β-thalassemia minor | 3 | 1 | ||
| Others | 2 | |||
*Hb, hemoglobin; IQR, interquartile range. NAM, newly arrived migrant; SMM, submicroscopic malaria; VFR, visiting friends and relatives.
†Patients with unknown malaria prophylaxis were not included in the statistical analysis.
‡Reference values: Hb 13.5–16.5 g/dL; platelets 130–450 × 1,000/μL; eosinophils 20–450/μL; total bilirubin 0.3–1.2 mg/dL; alanine aminotransferase 10–50 IU/L; aspartate aminotransferase 1–50 IU/L; IgE 0–100 IU/mL.
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Page updated: January 18, 2019
Page reviewed: January 18, 2019
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