Respiratory Treatment and Prevention (Advances in Experimental Medicine and Biology)

(33.3 %, p¼0.670). In conclusion, malaria test should be used in patients

with fever after a journey from Africa. Malaria caused byPlasmodium

falciparumis the most common species of brought over malaria. Mixed-

speciesPlasmodium falciparumandPlasmodium malariaeare uncommon

in travelers with malaria.

Keywords

Malaria parasites • Malaria symptoms • Malaria treatment • Mosquito •

Prophylaxis • Traveler malaria • Tropical disease

1 Introduction

Malaria is an acute infectious disease that can
become life threatening within a short time (WHO
2016 ;Burchard2011 ; Gyorkos et al.1995 ). It is
considered a tropical disease. Malaria is caused by
Plasmodium. There are four known human patho-
genicPlasmodiumspecies:Plasmodium malariae,
Plasmodium falciparum,Plasmodium vivax,and
Plasmodium ovale.Malaria parasites are transmit-
ted through the bite ofAnophelesmosquito. Malaria
can be either benign or malignant. The benign form
is known as quartan malaria and tertian malaria, and
the malignant form is malaria tropica (Lalloo
et al.2007 ).Plasmodium malariaecauses malaria
quartan,Plasmodium vivaxandovalecause malaria
tertian, andPlasmodium falciparumcauses malaria
tropica.Plasmodium falciparum infects a large
number of red blood cells and quickly advances to
a severe or life-threatening multi-organ disease.
Mixed infections with more than one species of
parasite can occur; such infections commonly
involvePlasmodium falciparumwith the attendant
risk of severe malaria (Lalloo et al.2007 ).
Malaria is mostly brought over to Europe by
travelers or immigrants from tropical and sub-
tropical geographic regions (Burchard 2011 ).
Epidemiological evidence shows that the origin
of infection is correlated with patterns of migra-
tion in European countries, i.e., many cases are
travelers who have returned to their country of
origin. Because the clinical symptoms of malaria
are nonspecific and can be difficult to distinguish
from a variety of other febrile diseases, malaria
must be considered in patients with a fever of
unknown origin and a travel history (Burchard

2011 ). As malaria is not often seen in Europe, its

underrecognition by physicians is likely.

Underrecognition or misdiagnosis of malaria

may also have to do with the fact that it is qute

often contracted by travelers residing for a short

time in an endemic region, which decreases

physicians’ attentiveness to this possibility

(Kalinowska-Nowak et al. 2012 ). Clinicians

working in highly urbanized areas with signifi-

cant immigrant communities may see higher

numbers of cases of malaria. However, as tour-

ism and globalization are increasing worldwide,

it is possible that the number of cases of malaria

will increase. Chemoprophylaxis could be help-

ful in lowering the malaria risk, and it forms one

of the key components of prevention of bringing

malaria over. According to the World Health

Organization’s (WHO 2010 ) ABCD approach

to malaria prevention, travelers should: have

awareness of risk, avoid being bitten by

mosquitoes, take chemoprophylaxis correctly,

and promptly search fordiagnosis and treatment.

Travel agents and health practitioners should

offer sufficient information about chemoprophy-

laxis to all travelers to malaria-endemic areas

(Gyorkos et al. 1995 ). This presupposes that the

provision of correct information will be effec-

tive, but this is not always the case. There are

various reasons for the non-uptake of chemopro-

phylaxis, and travelers’ receiving incorrect infor-

mation is just one possibility (Behrens and

Alexander 2013 ; Morgan and Figueroa-Mun ̃oz

2005 ).

The present investigation was conducted to

analyze the time trends of malaria brought over

to the German town of Homburg. Homburg is

36 J. Yayan and K. Rasche