Fever is a common symptom among returned ill-travellers and has many possible etiologies. Of potential causes, malaria is by far the most frequent diagnosis leading to hospitalization and death among travellers.
Delayed clearance of Plasmodium falciparum by artemisinin-based combination therapies (ACTs) has already been observed in African isolates. Here, we aimed to investigate the prevalence of polymorphisms in two genes correlated with delayed parasite clearance, P. falciparum Kelch 13 (PfK13) and ubiquitin-specific protease 1 (pfubp1), among returning travellers from African countries reported in eastern China and to provide baseline data for antimalarial drug resistance (ART) surveillance and evaluation.
PCR can be positive weeks after effective malaria treatment, potentially leading to over diagnose of recrudescence and re-infections. The DNA detected by PCR post-treatment might stem from residuals of destroyed asexual parasites, or from live gametocytes. The objective of this clinical observational study was to describe the presence of positive PCR for Plasmodium falciparum and Plasmodium vivax in follow-up samples post-treatment from returned travellers, and the proportion of positive PCR due to gametocytes.
To monitor drug resistance in Plasmodium vivax, a multidrug resistance 1 (Pvmdr1) gene and a putative transporter protein (Pvcrt-o) gene were used as molecular markers for chloroquine resistance. The biomarkers, the dihydrofolate reductase (Pvdhfr) gene and the dihydropteroate synthetase (Pvdhps) gene, were also used for the detection of resistance to sulphadoxine-pyrimethamine (SP); this drug is often accidentally used to treat P. vivax infections. Clinical blood samples (n = 120) were collected from patients who had been to one of eight malaria-endemic countries and diagnosed with P. vivax infection.
The aim of this systematic review was to identify predictors of actual or intended adherence with malaria chemoprophylaxis amongst travellers from non-endemic countries visiting endemic countries.
Malaria (Plasmodium spp) remains a top cause of travel-associated morbidity among European residents. Here, we describe recent trends of imported malaria to Belgium and characterize the first cases of P.falciparum failure to artemisinin combination therapy (ACT).