9–12 The objective of this retrospective study was to describe the travel patterns, clinical characteristics, and the drug regimens used for the treatment of imported malaria in Milano, Italy and compare it with published

series from Europe, North America, and Pacific regions. The site of our study, Luigi Sacco Hospital in Milano, Italy, is a 550-bed teaching hospital that is the reference infectious disease hospital of the metropolitan area of Milano. All smear-positive malaria cases diagnosed between 1998 and 2007 at the II and III Division of Infectious Diseases were reviewed. Diagnosis and Plasmodium species identification were based on thin and thick malaria-positive smears stained with 5% Giemsa stain and examined by experienced laboratory personnel. Medical records were captured retrospectively, and data were entered into a malaria chart review form that Alectinib was made in 2007 with the following items: demographic information (ie, age, sex, and

nationality), travel history (ie, country of visit and length of stay, interval between date of return to Italy and diagnosis), immigration status, anti-malarial chemoprophylaxis use, interval between the date of onset of symptoms and the diagnosis, symptoms and signs, laboratory parameters, glucose-6-phospatedehydrogenase testing in patients given primaquine, drug therapy and adverse events, fever clearance, and outcome. The immunologic Docetaxel chemical structure status of patients relative to malaria infection was categorized as either non-immune or semi-immune; those classified as semi-immune either had reported a history of previous malaria see more or had been born in and recently emigrated from an endemic area. For the purpose of our analysis anemia was defined as a hemoglobin level of less than 12 g/dL; leukopenia as a white blood cell count of less than 4,000/µL;

thrombocytopenia as a value of less than 150,000/µL. Severe malaria was defined according to the last published World Health Organization (WHO) criteria.13 Appropriateness of anti-malarial treatment was assessed using as references published guidelines from the Centers for Disease Control and Prevention referred to the period of observation of the patients and taking into account the drugs available in our country.9 Comparison of categorical variables were performed using the chi-squared test or Fisher’s exact test (two-tailed), depending on which was appropriate. Numerical variables were compared using t-test or the Mann–Whitney rank-sum test based on the distribution. All analyses were performed by using statistical software (SPSS version 15.0, SPSS Inc., Chicago, IL, USA). The limit of significance was p < 0.05. During the study period, 291 cases of malaria were diagnosed in non-immune (204, 70.1%) or semi-immune individuals (87, 29.9%). There were 186 male (63.9%) and 105 female (36.