Imported non-Plasmodium falciparum malaria: a five-year prospective study in a European referral center.
From 2000 to 2005, we investigated prospectively 98 cases of imported non-Plasmodium falciparum malaria (48 Plasmodium vivax, 34 P. ovale, and 16 P. malariae). Latency period between return and clinical attack exceeded three months in 40% of the patients. It was longer in travelers who had taken chemoprophylaxis. Time to diagnosis was longer in patients with P. malariae infection and in those with late-onset first attack. Parasite density was often lower than 500/microL, especially in P. ovale malaria. Relapses were diagnosed in 18% of all malaria episodes. Eight (17%) P. vivax and 2 (6%) P. ovale malaria episodes were due to relapse despite standard primaquine therapy. Diagnosis of imported non-falciparum malaria is often challenged by long latency period and low parasite density. In addition, the substantial relapse rate despite standard primaquine therapy supports the use of a higher dose of primaquine to eradicate P. vivax and P. ovale malaria effectively.
Bottieau
Emmanuel
E
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. ebottieau@itg.be
Clerinx
Jan
J
Van Den Enden
Erwin
E
Van Esbroeck
Marjan
M
Colebunders
Robert
R
Van Gompel
Alfons
A
Van Den Ende
Jef
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D005843:Geography; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010961:Plasmodium / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity; D011319:Primaquine / Q000008:administration & dosage; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D014195:Travel
D000962:Antimalarials; D011319:Primaquine