Vol 73, No 1 (2022)
Case report
Published online: 2022-03-31

open access

Page views 5401
Article views/downloads 880
Get Citation

Connect on Social Media

Connect on Social Media

Challenges in the diagnosis and treatment of malaria in Polish workers returning from Africa: a case series and review of literature

Natalia Kulawiak1, Sebastian Borys2, Anna Roszko-Wysokińska2, Natalia Zgud-Jankowska1, Krzysztof Korzeniewski34, Katarzyna Sikorska13
Pubmed: 35380173
IMH 2022;73(1):46-51.


Malaria is a parasitic disease caused in humans by five species of Plasmodium: P. falciparum, P. vivax, P. malariae, P. ovale, and P. knowlesi and transmitted through a female mosquito bite. In 2020, there were 241 million cases of malaria worldwide including 627,000 deaths. Traveling to malaria endemic areas is a significant risk factor, therefore, it is very important to use non-specific and pharmacological prophylaxis. Malaria symptoms usually appear 10–14 days after infection and the disease may be suspected, based on patient examination and medical history, in patients with fever who have stayed in malaria endemic areas. The initial symptoms of the disease are not pathognomonic and it is important to remember that not all malaria patients develop a fever. A prerequisite for successful treatment of this potentially life-threatening disease is well-targeted, timely diagnosis and immediate implementation of antiparasitic therapy. Despite significant progress in the fight against malaria across the world, the disease still poses a diagnostic and therapeutic challenge, especially when it develops as a result of an imported infection and when diagnosis is complicated by the presence of other diseases. A professional group that requires special attention are maritime workers. In this study we present clinical cases of malaria which show how important it is in the clinical practice of various specialists to include malaria in the differential diagnosis of patients with fever returning from tropical regions.

Article available in PDF format

View PDF Download PDF file


  1. Tan KT, Arguin PM. Yellow Book 2020. Malaria. Oxford University Press:, New York 2020: 267–287.
  2. Velasco E, Gomez-Barroso D, Varela C, et al. Non-imported malaria in non-endemic countries: a review of cases in Spain. Malar J. 2017; 16(1): 260.
  3. Piperaki ET, Daikos GL. Malaria in Europe: emerging threat or minor nuisance? Clin Microbiol Infect. 2016; 22(6): 487–493.
  4. Severe malaria. Trop Med Int Health. 2014; 19 Suppl 1: 7–131.
  5. Alenou LD, Etang J. Airport malaria in non-endemic areas: new insights into mosquito vectors, case management and major challenges. Microorganisms. 2021; 9(10).
  6. Guillet P, Germain MC, Giacomini T, et al. Origin and prevention of airport malaria in France. Trop Med Int Health. 1998; 3(9): 700–705.
  7. Bouvier M, Pittet D, Loutan L, et al. [Airport malaria: mini-epidemic in Switzerland]. Schweiz Med Wochenschr. 1990; 120(34): 1217–1222.
  8. Isadcson M. Airport malaria: a review. Bull World Health Organ. 1989; 67(6): 737–743.
  9. WHO. World Malaria Report 2021. World Health Organization: Geneva, Switzerland. https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2021.n (6 Dec 2020).
  10. Centers for Disease Control and Prevention. Malaria's Impact Worldwide. Global Health, Division of Parasitic Diseases and Malaria. https://www.cdc.gov/malaria/malaria_worldwide/impact.html (26 Jan 2021).
  11. WHO Guidelines for malaria, 2021. World Health Organization: Geneva, Switzeland. 13 July 2021 (ppData/Local/Temp/WHO-UCN-GMP-2021.01-eng.pdf).
  12. Morgan GS, Chiodini P, Evans M. Relapsing malaria: two cases of malaria presenting 8 months after return from Africa despite adherence to antimalarial chemoprophylaxis. Br J Gen Pract. 2012; 62(603): 555–556.
  13. Dorsey G, Gandhi M, Oyugi JH, et al. Difficulties in the prevention, diagnosis, and treatment of imported malaria. Arch Intern Med. 2000; 160(16): 2505–2510.
  14. Weber R, Schlagenhauf P, Amsler L, et al. Knowledge, attitudes and practices of business travelers regarding malaria risk and prevention. J Travel Med. 2003; 10(4): 219–224.
  15. Lim PL, Han P, Chen LH, et al. GeoSentinel Surveillance Network. Expatriates ill after travel: results from the Geosentinel Surveillance Network. BMC Infect Dis. 2012; 12: 386.
  16. Burdon J. Use of malarial prophylaxis amongst a population of expatriate church workers in Northeast Zaire. J Travel Med. 1998; 5(1): 36–38.
  17. Angelo KM, Libman M, Caumes E, et al. GeoSentinel Network. Malaria after international travel: a GeoSentinel analysis, 2003-2016. Malar J. 2017; 16(1): 293.
  18. South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) group. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. The Lancet. 2005; 366(9487): 717–725.
  19. Murdoch D. Diseases potentially acquired by travel to West Africa. https://www.uptodate.com/contents/diseases-potentially-acquired-by-travel-to-central-africa (Jan 21, 2021).
  20. World Health Organization. Elimination of malaria. Chapter 5. World Malaria Report 2009. ttps://apps.who.int/iris/bitstream/handle/10665/44234/9789241563901_eng.pdf.