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  • Title: Evidence for undetected malaria infection in non-immune Australian travellers not taking chemoprophylaxis.
    Author: Seed CR, Hamzah J, Davis TM.
    Journal: Acta Trop; 2006 Aug; 99(1):62-6. PubMed ID: 16916494.
    Abstract:
    To determine whether travellers from malaria-free countries can develop unrecognised or asymptomatic malaria after visiting endemic areas, we analysed data from 751 prospective blood donors who had visited or resided in malaria-risk areas in the previous 3 years. Malarial antibodies were measured using an established commercial enzyme-linked immunoassay incorporating four recombinant blood-stage plasmodial antigens and with published sensitivity > or =83% and specificity 100%. Details of countries visited and antimalarial chemoprophylaxis used were obtained by questionnaire. Among the 606 subjects resident in malaria-free countries and with no past history of malaria, 176 had visited high-risk countries as categorised by the World Health Organisation (WHO). Of these, 89 took no chemoprophylaxis including 6 (6.7%) who were antibody-positive; there were no antibody-positive subjects in the 87 who took chemoprophylaxis (P=0.029), which was that recommended by WHO in 84% of cases. These data underscore the value of effective antimalarial prophylaxis in non-immune travellers visiting high malaria-risk areas but also suggest that unrecognised infections can occur in those unprotected by chemoprophylaxis.
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