Education & Debate
نویسنده
چکیده
In the tropics malaria is a major killer, especially of young children in areas of intense transmission of Plasmodium fakiparum: there may be a million or more such deaths in Africa every year.' In parts of the world with no transmission of malaria (fig 1) returning travellers and visitors, infected elsewhere, continue to develop the illness. Twelve patients died of malaria in Britain in 1991; IO died in 1992. Of the four species of plasmodium that commonly cause human infections, one-P falciparum-is responsible for nearly all malaria deaths. The othersP vivax, P ovale, and P malariae-cause febrile illnesses that are troublesome but rarely fatal. The increased incidence of "imported" malaria in Britain since the 1970s has been due largely to a steady increase in the incidence ofPfakiparum infections (fig 2). Several factors have combined to increase the problem of imported malaria in Britain and other industrial nations: increased travel (more malaria infections); increasing resistance of Pfalcipanum,2 and recently of P vivax,3 to chemoprophylactic drugs (more infections progressing to disease); inadequate or neglected travel advice (more infections and disease); and delayed diagnosis and treatment (progression of falciparum malaria to life threatening disease).
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