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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/µL, 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.

Received November 8, 2005. Accepted for publication February 23, 2006.

Disclaimer: There is no potential conflict of interest with any of the authors.

^* Address correspondence to Emmanuel Bottieau, Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium. E-mail: ebottieau{at}itg.be

Authors’ addresses: Emmanuel Bottieau, Jan Clerinx, Erwin Van den Enden, Marjan Van Esbroeck, and Alfons Van Gompel, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, Telephone: 32-3-247-6405, Fax: 32-3-247-6452, E-mail: ebottieau{at}itg.be. Robert Colebunders and Jef Van den Ende, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, and Department of Tropical Diseases, University Hospital, Antwerp, Belgium, Telephone: 32-3-821-5256, Fax: 32-3-825-4785.

Reprint requests: Emmanuel Bottieau, Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium. Tel: + 32 3 247 64 05, Fax: + 32 3 247 64 52, E-mail: ebottieau{at}itg.be.

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