Background: Imported malaria remains a relevant clinical problem in Europe due to the rapid potential progression to severe and life-threatening disease, especially in non-immune patients and in the context in which diagnosis might be delayed due to lack of awareness of clinicians. In Portugal, malaria is a mandatory notifiable disease. In 2021 there were 79 cases reported to the Public Health System, but it is believed that cases are under-reported. Materials and Methods: In this retrospective observational study we analysed the medical records of 163 patients with Plasmodium spp infection, admitted in the infectious disease ward between March 2013 and March 2023. We analysed epidemiology, clinical features and risk factors for imported severe malaria. Results: Being male (p value: 0.028), older age (p value: 0.013), underlying chronic medical conditions (p value 0,005) and alcohol overuse (p value: 0.017) were identified as risk factors for severe malaria. Finding jaundice at presentation is also associated with severe disease (p value: < 0.001), as well as polypnea (p value: 0.016), postural hypotension (p value: 0.005), impaired consciousness (p value: 0.015) and prostration (p value: < 0.001). Blood test findings associated with severe malaria were the presence of anemia (p value < 0.001); elevation of transaminases (p value < 0.001); elevation of serum bilirubin (p value < 0.001); acute kidney injury (p value < 0.001) and leukocytosis (p value: 0.016). Discussion and conclusion: Primary and secondary prevention measures, such as pre-travel consultations, chemoprophylaxis, and early diagnosis and treatment, should be emphasized and improved among high-risk prospective travelers to malaria endemic countries. This finding should prompt clinicians to advise men, older travelers and travelers with underlying chronic medical conditions on malaria prevention, and highlights the need for early diagnosis and treatment for patients with early symptoms of malaria.
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Gonç, N. C. , alves, Gonç, Cristóvã, A. , o, Almeida, V. , Joã, Caria, O. , Carlos, M. , Magalhã, S. , es, Valadas, R. , Guerreiro, M. , Neto, S. , Cerqueira, B. , Ramirez, F. , Manata, M. J. and Maltez, F. (2026). Epidemiology, Clinical Features and Risk Factors for Imported Severe Malaria: Ten Years of Experience in a European Infectious Diseases Center. Open Access Library Journal, 13, e14619. doi: http://dx.doi.org/10.4236/oalib.1114619.
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