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Clinical Findings in Migrants With Asymptomatic Plasmodium Infections.
Isabelle Eliasson1,2, Katja Wyss1,2, Rebecca Tafesse Bogale1
1Division of Infectious Diseases, Department of Medicine Solna and Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
Open Forum Infectious Diseases
|September 11, 2025
Summary
Migrants with asymptomatic malaria often show splenomegaly and anemia. Early screening and treatment of subclinical Plasmodium infections in migrants are recommended to prevent adverse health outcomes.
Area of Science:
- Infectious Diseases
- Tropical Medicine
- Public Health
Background:
- Asymptomatic Plasmodium infections can persist in migrants relocated from malaria-endemic areas to nonendemic countries.
- Current recommendations for screening and treating asymptomatic malaria in migrant populations are limited.
- This study aimed to characterize subclinical Plasmodium infections in migrants to guide screening and management strategies.
Purpose of the Study:
- To explore the clinical features of subclinical blood-stage Plasmodium infections in migrants.
- To inform the development of effective screening and management protocols for asymptomatic malaria in migrant populations.
- To compare clinical and laboratory findings between malaria PCR-positive and PCR-negative individuals.
Main Methods:
- A retrospective observational study design was employed.
- Clinical data from medical records of asymptomatic sub-Saharan African migrants were analyzed.
- Malaria polymerase chain reaction (PCR) was used to identify Plasmodium infections; PCR-negative individuals were assessed for schistosomiasis and/or strongyloidiasis.
Main Results:
- Plasmodium PCR-positive individuals (n=65) showed a higher prevalence of anemia (21.1% vs 6.1%), elevated erythrocyte sedimentation rate (ESR) (58.1% vs 25.0%), raised immunoglobulin M (30.5% vs 10.5%), and splenomegaly (25.4% vs 2.5%) compared to PCR-negative individuals (n=54).
- Significant differences were observed in anemia (P = .048), ESR (P = .008), IgM (P = .030), and splenomegaly (P = .002).
- Antimalarial treatment led to improvement in splenomegaly and laboratory parameters in Plasmodium-infected individuals.
Conclusions:
- Subclinical Plasmodium infection in migrants is associated with a significant proportion of splenomegaly and abnormal laboratory findings, including anemia and elevated ESR.
- Screening and treatment of asymptomatic malaria infections are crucial for preventing adverse health outcomes.
- Consideration of screening and treatment strategies for subclinical malaria is warranted in both endemic and nonendemic settings.
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