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J Paediatr Child Health. 2015 Sep;51(9):920-3. doi: 10.1111/jpc.12870. Epub 2015 Mar 25.

Malaria in Sydney, Australia: Lessons learned from case management.

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The Children's Hospital at Westmead and the Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.



To evaluate the clinical presentation and profile of malaria cases diagnosed at a tertiary children's hospital in Australia


A retrospective file review of children diagnosed with malaria at the Children's Hospital Westmead from 1 January 2000 to 31 December 2010.


During the 11-year study period, 40 children were diagnosed with malaria; 30 (75%) presented with fever; 14 (35%) complained of nausea, vomiting or abdominal pain; and eight (20%) were completely asymptomatic. The median time between arrival in Australia and malaria diagnosis was 32 (range 4-434) days. Sixteen (40%) were refugees from sub-Saharan Africa, six (15%) were immigrants from South-East Asia, and seven (18%) recently travelled to or visited friends and family in malaria-endemic areas. Most (68%) cases had Plasmodium falciparum; Plasmodium vivax was identified in four cases with exposures in India and Papua New Guinea; one had mixed P. falciparum and P. vivax infection.


Malaria signs and symptoms were non-specific, with an absence of fever in a quarter of cases. Diagnostic vigilance is required in all children with potential malaria exposure in the preceding year. Asymptomatic parasitaemia should be considered in recent migrants from malaria-endemic areas.


chemoprophylaxis; child; malaria; refugee; travel

[Indexed for MEDLINE]

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