Epidemiology, Clinical Features and Risk Factors for Imported Severe Malaria: Ten Years of Experience in a European Infectious Diseases Center

Background: Imported malaria remains a relevant clinical problem in Europe due to the rapid potential progression to severe and life-threatening disease, especially in non-immune patients and in the context in which diagnosis might be delayed due to lack of awareness among clinicians.In Portugal, malaria is a mandatory notifiable disease.In 2021, there were 79 cases reported to the Public Health System, but it is believed that cases are under-reported.Materials and Methods: In this retrospective observational study, we analysed the medical records of 163 patients with Plasmodium spp infection, admitted in the infectious disease ward between March 2013 and March 2023.We analysed epidemiology, clinical features and risk factors for imported severe malaria.Results: Being male (p value: 0.028), older age (p value: 0.013), underlying chronic medical conditions (p value: 0.005) and alcohol overuse (p value: 0.017) were identified as risk factors for severe malaria.Finding jaundice at presentation is also associated with severe disease (p value: