Malaria: An indigenous case in Tunisia

Abstract

Background: Malaria, eradicated in Tunisia since 1979, still presents a potential threat of resurgence given the persistence of local anophelitism. Aim: Describe the clinical and epidemiological characteristics of a presumed indigenous P. falciparum malaria case identified in June 2023. Methods: This is a clinical case report with an epidemiological analysis of a severe malaria case diagnosed at the Pediatrics Department A of the Children's Hospital of Tunis in July 2023. Results: A 30-month-old male child was admitted for a prolonged febrile illness with gastrointestinal symptoms. The physical examination revealed fever with agitation, polypnea, tachycardia without signs of peripheral hypoperfusion, and hepatosplenomegaly. Leuko-thrombocytopenia with a biological inflammatory syndrome were found in biology. Malaria diagnosis was initially suggested on a blood smear then confirmed by rapid test and thick smear with parasitemia at 6%. Given the presence of severe criteria, treatment was initiated in the intensive care unit with a favorable clinical-biological evolution. Entomological and epidemiological investigations concluded a probable indigenous case. Conclusion: The presence of an indigenous malaria case enforces drastic prevention measures as well as the establishment of an epidemiological surveillance system.