The role of emergency departments in the treatment of imported severe and uncomplicated malaria – a retrospective monocentric observational study in a German university hospital

Abstract

Malaria is the most important parasitic disease worldwide, and the first cause of fever in returning travelers. There is insufficient knowledge about the specific healthcare structures where patients with imported malaria are treated. It is presumed that emergency departments (ED) play a significant role in the diagnosis and treatment of malaria. More precise data on how many patients with malaria present to the ED are currently very limited. It is also unknown how severely these patients are affected, how many of them need to be admitted for inpatient care, what therapy is initiated, and how their condition progresses. We conducted a monocentric retrospective study on adult emergency patients treated in the ED of the LMU University Hospital Munich, Germany between January 2019 and December 2023. 24 patients were treated in our ED with imported malaria. In 22 patients, an infection with Plasmodium (P.) falciparum was identified, while 1 patient had an infection with P. ovale, and another patient had an infection with P. vivax. 19 patients had uncomplicated malaria, and 5 patients developed severe malaria. 20 patients received inpatient treatment, with 15 having uncomplicated and 5 having severe malaria. There were no fatalities in the patient cohort during hospital stay. ED play a crucial role in the care of patients with malaria. Our work presents for the first time extensive and detailed data on diagnosis, patient characteristics, laboratory and clinical parameters, therapy, and outcomes of these patients in the ED of a large German university hospital.