投稿分類 其他

主委發表種類: 壁報

投稿標題(中): 境外移入瘧疾個案之有效感染管制措施：案例研究

投稿標題(英): An overview of infection control operations for imported malaria cases

投稿摘要(前言): Malaria is an infectious disease caused by Plasmodium parasites, primarily transmitted through bites from infected mosquitoes. With the acceleration of globalization, imported malaria cases have gradually increased, posing significant challenges to public health. This article aims to explore infection control procedures for imported malaria cases, analyzing the challenges faced and corresponding measures. In December 1965, the WHO officially declared Taiwan malaria-free. However, occasional imported cases continue to occur, with the number rising from two cases in 2020 to eight in 2024. When a confirmed case arises, infection control personnel may feel uncertain about how to manage a series of infection control procedures. These procedures include patient education, patient isolation, environmental control of confirmed cases, notifiable disease reporting, specimen collection and testing, special applications for imported antimalarial medications, monitoring of drug side effects, and case closure upon recovery. Through sharing this experience, it is hoped that infection control professionals will gain clarity, ensuring patients receive thorough treatment and enhancing the effectiveness of infection control policies.

投稿摘要(方法): Case study -- Case A involves a 26-year-old male of Ethiopian nationality who entered Taiwan on September 16 to study at a university of technology in New Taipei City. He had been experiencing intermittent chills and fever since early August and had received three days of unspecified medication in Ethiopia. He departed Ethiopia on September 14, transferred in Beijing on September 15, and arrived in Taiwan on September 16. On September 23, he visited a hospital with no fever, reporting that he had been notified in Ethiopia that he might have malaria.

投稿摘要(結果): The case was immediately reported as a notifiable disease (malaria), and samples, including whole blood, thick, and thin blood smears, were sent for testing, all confirming Plasmodium vivax infection. He began taking “Plaquenil” under National Health Insurance coverage on September 23 and switched to the CDC-provided medication “Artemether-lumefantrine”on September 24 for three days. Re-apply “Primaquine” (15mg/tab) 14 tab on September 27 for 2 weeks. Conducted an investigation on the side effects of medication on September 27, October 11, and October 24. No adverse drug reactions were reported in all three investigations of drug side effects. Samples taken on September 23-24 tested positive for malaria, with both thin and thick blood smears showing Plasmodium vivax rings, active parasites, schizonts, and gametocytes. PCR testing on the whole blood sample confirmed Plasmodium vivax. On September 24, the blood smears continued to show active parasites and gametocytes. Samples taken on September 25-26 and October 24 tested negative, and the case was therefore closed on October 24.

投稿摘要(討論): On the day of the consultation, the patient was advised to avoid mosquito bites and to sleep under a mosquito net. He was prescribed oral Plaquenil under the National Health Insurance coverage until he could switch to Artemether-lumefantrine, Primaquine, a special medication provided by the CDC (applied for through the CDC website’s special anti-parasitic medication import application form). Following the medication regimen, the patient was monitored on days 3, 7, 14, and 30. If no abnormalities were detected, the case could be closed.If not promptly controlled, imported malaria cases could lead to local outbreaks, significantly impacting public health. Strengthening health monitoring of travelers returning from abroad and screening for malaria in patients with symptoms like fever and headache can aid in early case detection. It is also essential to educate travelers on malaria prevention measures, such as using mosquito repellent and sleeping under a net while traveling. Healthcare institutions should establish robust malaria diagnosis and treatment protocols to ensure that medical personnel can quickly identify and manage suspected cases. Managing infection control for imported malaria cases presents a major public health challenge. By enhancing case monitoring, raising public awareness, improving healthcare systems, and fostering international collaboration, the risk of malaria transmission can be effectively reduced, thereby protecting public health. Continued attention to malaria trends and timely adjustments in prevention strategies will be essential to address the evolving epidemic situation.

稿件檔: