ArticleLe infezioni in medicina2026
Epidemiology of imported malaria in an area of North-Eastern Italy (2016-2025): clinical focus on cerebral malaria.
Article in Le infezioni in medicina, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In non-endemic settings, imported malaria poses diagnostic challenges due to non-specific presentations and lack of immunity, especially in visiting friends and relatives (VFRs). Focusing on the Western Friuli (Italy) observatory, this work aims to optimize triage by identifying early severity predictors. Through the analysis of clinical parameters, paediatric cerebral cases, and host genetics - including an illustrative case of HbS/β-thalassaemia - we evaluate the drivers of Methods: This retrospective study (2016-2025) analysed symptomatic malaria cases in the Friuli Occidentale Health Authority, combining epidemiological data with illustrative clinical cases. Diagnosis was confirmed via microscopy and molecular methods. Using WHO/AMCLI criteria, we evaluated admission parameters, including procalcitonin (PCT), C-reactive protein (CRP), and platelet count, to identify predictors of severe malaria, adopting a ≥2% parasitaemia threshold. Diagnostic accuracy was assessed via multivariable logistic regression and ROC analysis. Results: Of the 124 malaria cases ( Conclusions: Imported malaria remains a critical challenge due to unpredictable severity trends and non-specific onset of CM. PCT, combined with parasitaemia, outperformed CRP and platelet count as an independent predictor of severity. High PCT levels should serve as a "red flag" for immediate triage and parenteral therapy. Integrating PCT into clinical guidelines is essential for effective risk stratification and preventing life-threatening complications in non-endemic settings.
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