title: Malaria in Sydney, Australia: Lessons learned from case management.
abstract: OBJECTIVE
  To evaluate the clinical presentation and profile of malaria cases diagnosed at a tertiary children's hospital in Australia
  
  
  METHODS
  A retrospective file review of children diagnosed with malaria at the Children's Hospital Westmead from 1 January 2000 to 31 December 2010.
  
  
  RESULTS
  During the 11-year study period, 40 children were diagnosed with malaria; 30 (75%) presented with fever; 14 (35%) complained of nausea, vomiting or abdominal pain; and eight (20%) were completely asymptomatic. The median time between arrival in Australia and malaria diagnosis was 32 (range 4-434) days. Sixteen (40%) were refugees from sub-Saharan Africa, six (15%) were immigrants from South-East Asia, and seven (18%) recently travelled to or visited friends and family in malaria-endemic areas. Most (68%) cases had Plasmodium falciparum; Plasmodium vivax was identified in four cases with exposures in India and Papua New Guinea; one had mixed P. falciparum and P. vivax infection.
  
  
  CONCLUSIONS
  Malaria signs and symptoms were non-specific, with an absence of fever in a quarter of cases. Diagnostic vigilance is required in all children with potential malaria exposure in the preceding year. Asymptomatic parasitaemia should be considered in recent migrants from malaria-endemic areas.
authors: The Children's Hospital at Westmead and the Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors: Kelly A
authors: KA
authors: Thompson
authors: The Children's Hospital at Westmead and the Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors: Ben J
authors: BJ
authors: Marais
authors: The Children's Hospital at Westmead and the Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors: Alison
authors: A
authors: Kesson
authors: The Children's Hospital at Westmead and the Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors: David
authors: D
authors: Isaacs
mesh_terms: D000293:Adolescent; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008485:Medical Audit; D009517:New South Wales / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: chemoprophylaxis; child; malaria; refugee; travel