Imported plasmodium ovale malaria from Côte d'Ivoire: a case report

Malaria remains a significant global health issue, with an estimated 263 million cases and 597,000 deaths reported in 2023. Plasmodium ovale, although less common than P. falciparum and P. vivax, presents diagnostic challenges due to its morphological resemblance to P. vivax and its ability to form latent liver-stage hypnozoites, leading to delayed relapses.

This case report describes a 29-year-old male who presented with fever, chills, and myalgia upon returning to Bogotá, Colombia, after a three-month stay in Côte d'Ivoire, Africa. Initial microscopy misidentified the parasite as P. falciparum, leading to diagnostic uncertainty. Polymerase chain reaction (PCR) confirmed P. ovale infection, emphasizing the critical role of molecular diagnostics in differentiating malaria species. The patient was treated with chloroquine and primaquine for radical cure. Initially, the patient received artemether-lumefantrine empirically. Once the diagnosis of P. ovale was confirmed, he was switched to chloroquine followed by primaquine (15 mg base daily for 28 days) as radical cure. G6PD testing was not available in our setting, but the patient was monitored clinically and tolerated the medication without adverse effects.

Given that P. ovale is not endemic to Colombia, increased awareness among clinicians is necessary for accurate diagnosis and management of imported malaria cases. Enhanced surveillance and advanced diagnostic techniques are essential to prevent misdiagnosis and ensure appropriate treatment.