Background: The aim of the present study was to analyze the epidemiologic aspects and particular features of malaria in immigrants in Catalonia, Spain.
Methods: All the immigrants who visited the Unit of Tropical and Imported Diseases "Drassanes" in Barcelona from endemic zones of malaria from 1990 to 1993 were studied. The diagnosis of malaria was based on the thick blood film, peripheral blood smear exam and, since 1991, the QBC (Quantitative Buffy Coat).
Results: One hundred three cases of malaria were diagnosed in 100 individuals from a total of 2,453 visited immigrants. Forty-four percent of the patients presented febrile syndrome, 11% cutaneous syndrome accompanied by other manifestations justifying the same, 9% presented other clinical manifestations and 36% were asymptomatic. Ninety-six percent of the subjects with parasites by Plasmodium were from sub-Saharan Africa and in 2 cases, both were produced by Plasmodium falciparum, with the length of time having been in Spain at the time of diagnosis being more than one year. P. falciparum represented 70% of the total cases, followed by P. malariae (15%), P. vivax (8%), Plasmodium spp. (6%) and P. ovale (1%).
Conclusions: Malaria by P. falciparum in semi-immune immigrants is not usually severe and follows an asymptomatic course in more than one third of the cases. The usual analysis for Plasmodium is recommended in immigrants from sub-Saharan Africa due to the high frequency of presentation and the absence of symptoms. Such analysis is not advised in groups from other areas except when suggestive symptoms are present.