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  • Title: A retrospective review of malaria cases seen in a non-endemic area of South Africa.
    Author: Dube S, Ismail N, Hoosen AA.
    Journal: Travel Med Infect Dis; 2008 Sep; 6(5):296-300. PubMed ID: 18760252.
    Abstract:
    BACKGROUND: Malaria is a risk for travelers to endemic areas. We describe the diagnosis and treatment of malaria in Pretoria, a non-endemic area in South Africa. METHODS: Records of specimens submitted to the medical microbiology laboratory for malaria investigations over 3 years were reviewed with follow up of hospital records for positive specimens for clinical data. The laboratory performs malaria smears and uses HRP2-Ag testing for rapid diagnosis of Plasmodium falciparum. RESULTS: A total of 516 specimens were received, with a 211/516 (41%) malaria smear positive rate. The number of malaria positive specimens has been increasing overtime and this increase was statistically significant in children [p=0.005]. HRP2-Ag testing was done on 430 specimens with124/430 (29%) being positive, of which 10/124 (8%) were smear negative, giving 98% sensitivity. Hospital records for 198/211 (94%) smear positive cases showed that 190/198 (96%) of the patients had a travel history with 170/190 (71%) having traveled to Mozambique, a malaria endemic country. Most patients presented with uncomplicated malaria; the CFR was 4/198 (2%). Treatment mainly followed South African national guidelines. CONCLUSION: Imported malaria is increasingly being diagnosed in returning travelers, especially from Mozambique. Rapid antigen tests remain useful for the diagnosis of malaria in non-endemic areas.
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