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Table 1 Malaria infections reported amongst the Pakistani asylum-seekers between July and December 2013

From: Characterization of imported malaria, the largest threat to sustained malaria elimination from Sri Lanka

Patient no.

Age

Sex

Malaria species

Stage/s

Summary of clinical history

1

8 yrs

F

Pv

Trophozoites (T)/Gametocytes (G)

Developed fever on the 3rd of July 2013, admitted to a District General Hospital (DGH) in the Western Province on the 8th of July and blood smear tested positive for malaria parasites on the 9th of July.

2

11 yrs

F

Pv

T/G

Fever for three days prior to admission to the DGH on the 12th of July and diagnosed with malaria on the same day.

Active case detection (ACD) for malaria carried out among the refugee population by microscopy and RDT by Public Health Laboratory Technicians (PHLTs) of the Anti Malaria Campaign from the 15 th – 18 th July 2013.

3*

42 yrs

M

Pv

T/G

Identified by ACD. Asymptomatic at the time of diagnosis. History of fever two days ago. Sought treatment from a General Practitioner but no blood smear done for diagnosis of malaria. Developed fever with chills and rigors immediately after admission to hospital.

4*

38 yrs

F

Pv

T/G

Identified by ACD. Asymptomatic at the time of diagnosis. History of Irregular fever over past 16 days. Sought treatment but no blood smear done for malaria diagnosis. Wife of case number 3.

5*

31 yrs

F

Pv

T/G

Identified by ACD. Asymptomatic at the time of diagnosis. 32 weeks pregnant. Flu like illness with chills over past one month. Received treatment for a urinary tract infection but no blood smear done for malaria diagnosis.

6*

7 yrs

M

Pv

T/G

Identified by ACD. Asymptomatic at the time of diagnosis. Irregular occurrence of fever over past 14 days. Sought treatment but no blood smear for malaria diagnosis.

7**

35 yrs

M

Pv

T/G

Screened by ACD and found to be negative. Presented with fever on the 22nd of July to the same DGH and was found to be positive for malaria.

8

22 yrs

M

Pv

T/G

Reported from the Teaching Hospital Anuradhapura in the North Central Province, a former high malaria endemic area. Originated from the same neighbourhood but working in this district for the past one month (was not present during ACD). Diagnosed with malaria on the 24th of July.

9**

9 yrs

M

Pv

T/G

Screened by ACD and found to be negative for malaria. Fever commenced one week after ACD on the 25th of July. Diagnosed on the 29th of July at the DGH.

10

25 yrs

F

Pv

T/G

Not screened by ACD by the PHLTs. Admitted to the same DGH 3 weeks later on the 5th of August with fever and diagnosed with malaria. Had been admitted to same hospital 10 days prior to this, been treated for dengue and discharged without having a blood smear examined for malaria parasites.

11**

2 yrs

M

Pv

T/G

The child of case number 3 and 4 who was found to be negative for malaria parasites by ACD. Admitted with fever on 18th of August to the DGH and diagnosed with malaria on the 20th of August.

Active case detection (ACD) for malaria carried out among the refugee population by microscopy and RDT by Public Health Laboratory Technicians (PHLTs) of the Anti Malaria Campaign on the 26th of August 2013.

12**

29 yrs

M

Pv

T/G

Screened by ACD and found to be negative for malaria. Presented with fever to the DGH and diagnosed with malaria on the 24th of September 2013.

13**

28 yrs

M

Pv

T/G

Screened by ACD and found to be negative for malaria by microscopy and RDT. Presented with fever to the DGH and diagnosed with malaria on the 28th of September.

14**

23 yrs

M

Pv

T

Screened during ACD done in July and found to be negative. Developed fever on the 28th of September and diagnosed with malaria on the 1st of October at the DGH.

Active case detection (ACD) for malaria carried out among the refugee population by microscopy and RDT by Public Health Laboratory Technicians (PHLTs) of the Anti Malaria Campaign on the 1 st of October 2013.

15

24 yrs

F

Pv

T/G

Arrived in Sri Lanka after last screening. History of irregular fever since the 2nd of November and diagnosed with malaria on the 18th of November.

16*

5 1/2 yrs

F

Pv

T/G

Identified by ACD. Asymptomatic at the time of diagnosis. History of irregular fever since the 1st of November and diagnosed with malaria on the 21st of November.

Active case detection (ACD) for malaria carried out among the refugee population by microscopy and RDT by Public Health Laboratory Technicians (PHLTs) of the Anti Malaria Campaign on the 21 st of November 2013

17**

22 yrs

M

Pv

G

Screened during ACD and found to be negative. History of irregular fever since the 4th of December and diagnosed with malaria on the 7th of December.

  1. *Diagnosed by active case detection by contact tracing.
  2. **Negative by active case detection but presented with fever on a later date and diagnosed with malaria.