Volume 77, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


A 27 week pregnant woman who had lived in Bangkok, Thailand, for 18 months presented to her obstetrician with a 1-week history of intermittent fever and malaise. Medical history was significant for multiple episodes of malaria during her 10 years of employment in sub-Saharan Africa before her relocation to Thailand. The initial malaria smear was negative. She returned a week later with no resolution of her symptoms, at which time she was found to have by microscopy and polymerase chain reaction. She had an excellent response to chloroquine, which she continued weekly until 36 weeks of gestation. She delivered a healthy term infant and received radical cure with primaquine after cessation of breastfeeding. This case shows challenging issues in detection and management of imported malaria.


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  1. Collins WE, Jeffery GM, 2005. Plasmodium ovale: parasite and disease. Clin Microbiol Rev 18 : 570–581.
  2. Richter J, Hoppenheit B, Muller-Stover I, Gobels K, Haussinger D, 2004. Case report: Plasmodium ovale infection acquired in Malawi. Trans R Soc Trop Med Hyg 98 : 751–752.
  3. Walker-Abbey A, Djokam RR, Eno A, Leke RF, Titanji VP, Fogako J, Sama G, Thuita LH, Beardslee E, Snounou G, Zhou A, Taylor DW, 2005. Malaria in pregnant Cameroonian women: the effect of age and gravidity on submicroscopic and mixed-species infections and multiple parasite genotypes. Am J Trop Med Hyg 72 : 229–235.
  4. Incardona S, Chy S, Chiv L, Nhem S, Sem R, Hewitt S, Doung S, Mercereau-Puijalon O, Fandeur T, 2005. Large sequence heterogeneity of the small subunit ribosomal RNA gene of Plasmodium ovale in Cambodia. Am J Trop Med Hyg 72 : 719–724.
  5. Paxton LA, Slutsker L, Schultz LJ, Luby SP, Meriwether R, Matson P, Sulzer AJ, 1996. Imported malaria in Montagnard refugees settling in North Carolina: implications for prevention and control. Am J Trop Med Hyg 54 : 54–57.
  6. Skarbinski J, James EM, Causer LM, Barber AM, Mali S, Nguyen-Dinh P, Roberts JM, Parise ME, Slutsker L, Newman RD, 2006. Malaria surveillance–United States, 2004. MMWR Surveill Summ 55 : 23–37.
  7. Win TT, Lin K, Mizuno S, Zhou M, Liu Q, Ferreira MU, Tantular IS, Kojima S, Ishii A, Kawamoto F, 2002. Wide distribution of Plasmodium ovale in Myanmar. Trop Med Int Health 7 : 231–239.
  8. Bottieau E, Clerinx J, Van Den Enden E, Van Esbroeck M, Colebunders R, Van Gompel A, Van Den Ende J, 2006. Imported non-Plasmodium falciparum malaria: a five-year prospective study in a European referral center. Am J Trop Med Hyg 75 : 133–138.
  9. Davis TM, Singh B, Sheridan G, 2001. Parasitic procrastination: late-presenting ovale malaria and schistosomiasis. Med J Aust 175 : 146–148.
  10. Collins WE, Jeffery GM, 2002. A retrospective examination of sporozoite-induced and trophozoite–induced infections with Plasmodium ovale: development of parasitologic and clinical immunity during primary infection. Am J Trop Med Hyg 66 : 492–502.
  11. McGready R, Davison BB, Stepniewska K, Cho T, Shee H, Brockman A, Udomsangpetch R, Looareesuwan S, White NJ, Meshnick SR, Nosten F, 2004. The effects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission. Am J Trop Med Hyg 70 : 398–407.
  12. Nosten F, McGready R, Simpson JA, Thwai KL, Balkan S, Cho T, Hkirijaroen L, Looareesuwan S, White NJ, 1999. Effects of Plasmodium vivax malaria in pregnancy. Lancet 354 : 546–549.
  13. Taylor WR, White NJ, 2004. Antimalarial drug toxicity: a review. Drug Saf 27 : 25–61.
  14. Phillips-Howard PA, Wood D, 1996. The safety of antimalarial drugs in pregnancy. Drug Saf 14 : 131–145.
  15. Wolfe MS, Cordero JF, 1985. Safety of chloroquine in chemosuppression of malaria during pregnancy. Br Med J (Clin Res Ed) 290 : 1466–1467.
  16. Whitty CJ, Edmonds S, Mutabingwa TK, 2005. Malaria in pregnancy. BJOG 112 : 1189–1195.
  17. CDC, 2005. Health Information for International Travel, 2005–2006. Atlanta, GA: US Department of Health and Human Services, Public Health Service.
  18. CDC, 2004. Treatment of Malaria (Guidelines for Clinicians). Available at: http://www.cdc.gov/malaria/diagnosis_treatment/tx_clnicians.htm.
  19. Hill DR, Baird JK, Parise ME, Lewis LS, Ryan ET, Magill AJ, 2006. Primaquine: report from CDC expert meeting on malaria chemoprophylaxis I. Am J Trop Med Hyg 75 : 402–415.
  20. Lalloo DG, Shingadia D, Pasvol G, Chiodini PL, Whitty CJ, Beeching NJ, Hill DR, Warrell DA, Bannister BA, 2007. UK malaria treatment guidelines. J Infect 54 : 111–121.

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  • Received : 29 May 2007
  • Accepted : 15 Jul 2007

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