Outpatient treatment of malaria in recently arrived African migrants

To describe the clinical features and management of African migrants recently arrived in Western Australia and subsequently diagnosed with malaria.

Retrospective case record analysis of African migrants aged > or = 16 years with malaria referred to Royal Perth Hospital (RPH) from the WA Migrant Health Unit (MHU) between 1 March 2003 and 30 September 2005.

Demographic variables; clinical and laboratory variables; Plasmodium species; antimalarial medications used and their efficacy.

57 (3.5%) of 1609 adult African migrants screened at the MHU were diagnosed with malaria and referred for treatment. 52 were infected with P. falciparum, two with P. ovale, one with P. malariae, and one with both P. falciparum and P. malariae; the malaria parasite could not be identified in one individual. No patients had severe malaria by World Health Organization criteria. Most patients (53/57) were treated as outpatients with oral antimalarial therapy; four patients without severe malaria were admitted to hospital for treatment and observation. Atovaquone-proguanil was the antimalarial medication most commonly used (in 52/57), and treatment was well tolerated in most patients. Post-treatment follow-up was possible in 50 patients; all 27 of those who were followed for 4 weeks or longer were cured. Cure could not be concluded in patients with shorter follow-up periods. All follow-up blood films were negative for malarial parasites.

Outpatient treatment of malaria in recently arrived adult African migrants appeared to be safe and efficacious in our cohort.