Emerging Infectious Diseases

Background: Malaria remains a major public health problem and a real threat to global health. According to WHO in 2015, there was an estimate of 212 million malaria cases with 429,000 deaths worldwide. This disease is endemic  in tropical and subtropical countries with a high risk for travelers. Morocco was certified in 2010 by WHO as free from endemic malaria transmission. Nevertheless, an increasing number of imported cases are reported each year. Thus, we studied its epidemiological characteristics to determine its trends and to guide recommendations for its control.

 

Methods: A retrospective descriptive study was conducted on reported cases from the surveillance system of  parasitic diseases at the Directorate of Epidemiology and Disease Control between 2011 and 2016. Frequencies and

proportions were calculated on socio-demographics data and trends.

 

Results: Our records showed a total of 2422 imported malaria cases including 26 deaths. The 3-year moving average reveals a slight constant trend increase (2%). Imported malaria was predominant among Moroccans (82.3%) than foreigners (17.7%). Males were over represented with a sex ratio of 12.2:1. The disease was reported by both civilian and military sectors (56% versus 44%). The median age was 32 years (range: 1 to 80). Outside the military, workers accounted for 48.6%, students 17% and the truckers 11.5%. Plasmodium falciparum was predominant (66%). Almost all of cases (96%) came from African countries. In 54% of cases, chemoprophylaxis was not taken by travelers.

 

Conclusion: Imported malaria is an important cause of morbidity and mortality. Prevention strategies for travelers

need to be strengthened in order to educate them on the need for prophylaxis and the importance of preventive

measures. In addition, targeting high-risk groups and strengthening continuous education training for clinicians

would significantly reduce the risk of imported malaria in Morocco.