Plasmodium ovale malaria in Brazil: report of an imported case with a prolonged incubation period

Abstract

We report the first case of imported Plasmodium ovale in Brazil, confirmed using both conventional microscopy and PCR-based protocols. The patient was a 36-year-old Brazilian male who had been working as a miner in Cabinda Province, Angola. Based on his travel history, the parasite was dormant for at least two years. The relatively long period of incubation of P. ovale may obscure the link between exposure and disease. The recent increase in the number of people travelling to regions where P. ovale is endemic, suggests that a PCR-based protocol should be included as a complementary tool for malaria reference laboratories.

Molecular characterization of misidentified Plasmodium ovale imported cases in Singapore

“…Plasmodium ovale can induce relapses that can occur a long time after the primary infection and over several years [ 5 , 9 , 88 ]. Six of the nine imported cases to Singapore in recent years were clearly due to relapsing P. ovale that had been acquired a few months to 4 years previously.…”

Primer reporte de un caso importado de Malaria por Plasmodium ovale curtisi en Paraguay, confirmado por diagnóstico molecular

“…A esto se suma que, el establecimiento de la SnM-PCR aumenta la sensibilidad y contribuye a la discriminación entre P. vivax y P. ovale quienes son morfológicamente similares (25,13,14).…”

“…Los reportes de casos de P. ovale importados de países de África recientemente, provienen de países como Brasil, China, Canadá y Malasia (13)(14)(15)(16).…”

Dengue infection as a potential trigger of an imported Plasmodium ovale malaria relapse or a long incubation period in a non-endemic malaria region

“…6,8 In Brazil, a total of 39 cases of P. ovale malaria have been recorded, showing a gradually increasing trend in recent years as a result of the migration of travelers from P. ovale-endemic regions. 9,10 The low prevalence of this parasite, combined with its morphological similarity to P. vivax and the low sensitivity of currently available rapid diagnostic tests, could increase the rates of P. ovale misdiagnosis.…”