Author/Editor		Bokal, Urška; Skralovnik, Ajda; Pikelj, Franjo
Title		Učinkovitost protimalarične kemoprofilakse - analiza obolevanja študentov medicine Sekcije za tropsko in potovalno medicino Medicinske fakultete v Ljubljani na humanitarnih odpravah v trope v letih 1990-2005
Translated title		Efficiency of antimalarial chemoprophylaxis - an analysis of malaria morbidity among members of Section for tropical medicine, Medical faculty of Ljubljana on electives in third world countries 1990-2005
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 76, št. 5
Publication year		2007
Volume		str. 297-301
Language		slo
Abstract		Background The aim of this study was to assess the incidence of malaria among the homogenous population of medical students and young doctors, specifically educated in tropical medicine, travelling to the third world countries for electives of two to four months' duration with professional and humanitarian purposes. We focused on the efficiency of currently widely reccomended antimalarial chemoprophylaxis, especially mefloquine. Methods The data were collected by a questionnaire, analysis of medical documentation and medical examinations of elective participants after their return. Malaria was diagnosed either microscopically or on basis of typical clinical features, followed by marked improvement after antimalarial therapy. Results From 106 expedition members that were adherent to regular exposure prophylactic measures as well as recommended chemoprophylaxis, 28 (26%) reported malaria. 23 (82%) among them visited Africa and 23 (82%) were taking mefloquine for chemoprophylaxis. None suffered from complicated form of disease. No statistically significant differences in malaria morbidity with reference to travel destination, gender or weather season were found. Conclusions High incidence of malaria in our population could be partially explained by a relatively long period of travel in malaria hyperendemic regions. We carefully examined thepossibility of erroneous diagnosis of malaria as well as probable increase in mefloquine resistance in hyperendemic rural regions of Africa. Absence of complicated malaria proves the benefits of complete adherence to antimalarial exposure and chemoprophylaxis.
Summary		Izhodišča Z raziskavo smo želeli proučiti obolevanje za malarijo pri mladi, zdravi in zdravstveno ozaveščeni populaciji študentov medicine in mladih zdravnikov, ki v okviru izbirnega predmeta tropska medicina odhajajo na nekajmesečne odprave v dežele tretjega sveta. Ob upoštevanju ekspozicijske profilakse smo pri naši populaciji želeli oceniti učinkovitost sodobnih antimalarikov, predvsem meflokina, pri kemoprofilaksi malarije. Metode Študija je potekala s pomočjo vprašalnika, analize medicinske dokumentacije in pregledov udeležencev odprav po povratku. Malarijo so udeleženci diagnosticirali z mikroskopiranjem krvnega razmaza in debele kaplje na osnovi značilne klinične slike in učinkovitosti protimalaričnega zdravljenja. Rezultati Od 106 udeležencev odprav, ki so dosledno upoštevali ekspozicijsko profilakso in aktualna priporočila SZO glede kemoprofilakse, jih je za malarijo zbolelo 28 (26%). Od tega jih je 23 (82%) potovalo v Afriko in 23 (82%) jih je za kemoprofilakso jemalo meflokin. Nihče ni zbolel za hudo obliko malarije. Statistično pomembnih razlik v obolevanju med posameznimi regijami potovanja, spoloma ali glede na sušno oziroma deževno dobo ni bilo. Zaključki Visoko stopnjo obolevanja za malarijo pri naši populaciji smo poskusili razložiti z razmeroma dolgo dobo potovanja v hiperendemične predele za malarijo, poudarili smo pomen pravilnosti diagnoze malarije in ustreznosti meflokina za protimalarično kemoprofilakso v hiperendemičnih ruralnih predelih tropske in savanske Afrike zaradi verjetnega razvoja večje stopnje rezistence plazmodijev. Odsotnost težkih oblik malarije med obolelimi potrjuje, da ob doslednem upoštevanju priporočene zaščite bolezen poteka v milejši obliki, ki ne ogroža življenja.
Descriptors		TROPICAL CLIMATE TRAVEL MALARIA ANTIMALARIALS CHEMOPREVENTION ADULT STUDENTS, MEDICAL