Diagnostic, clinical and therapeutic aspects of imported f. malaria in the republic of bulgaria, in patients treated at the clinic of infectious diseases - military medical academy, sofia

In the article we present six clinical cases of imported F. malaria during the period 2015-2023. All patients had returned to the Republic of Bulgaria from malaria endemic countries (specifically Uganda and Nigeria). In all cases, no antimalarial drug prophylaxis was performed in advance. The malaria was diagnosed after clinical symptoms (manifestation) at a different stage of the malarial attacks. The average period from the manifestation of the first symptoms to the diagnosis of malaria was 3.6 days. Initial parasitemia and parasitemia based on etiological treatment were reported. Patients were hospitalized on average 10 (± 1) days in an infectious disease clinic. In some of the patients, additional infections with COVID-19, Influenza A, Chlamydia pneumoniae, Mycoplasma pneumoniae were also found. Etiological therapy of persons with proven infectious diseases was carried out with good result. As a result of the etiological treatment with mono- and combined antimalarial drugs, in addition to symptomatic and pathogenetic treatment, an effect, in terms of the healing process and negative results in malaria testing was established. The antimalarial treatment had laboratory proven hepatoschizontocidal, hemoschizontocidal and gametocidal effect. After three negative malaria morphodiagnostic tests, the patients were discharged clinically healthy and parasitologically negative. They were referred for outpatient care and further monitoring by the GP at the place of residence for a period of one year, with testing for malaria at every febrile condition. Currently, there are no registered medications for the etiological treatment of malaria in the country.