Table 2 Summary of patients who arrived from Sierra Leone, Africa and tested positive for malaria

1

M

Pf

Ring stage (R)

Fever for three days since the 15^th of August. Admitted to a tertiary care Teaching hospital in the Western Province (traditionally malaria non-endemic area) and diagnosed with malaria by microscopy and RDT on the 18^th of August

2*

M

Pf

R

Identified by ACD. On tracing patient had been admitted with fever, chills and rigors to a hospital in a previous malaria endemic area on the 12^th of August. Malaria blood smear had not been done in-spite of giving a history of returning from a malaria endemic country until informed by AMC HQs. Found to be positive on the 19^th of August. Following first dose of ACT patient developed severe malaria with haematuria and drowsiness. Treated with IV quinine in the intensive care unit and made full recovery without sequale.

3*

M

Pf

RDT + Microscopy negative

Identified by ACD. Asymptomatic at the time of diagnosis on the 19^th of August. Patient refused to get admitted following diagnosis and was treated by DOTS at home.

4*

M

Pf

R

Identified by ACD. Asymptomatic at the time of diagnosis on the 21^st of August. Admitted to hospital and treated by DOTS.

5*

M

Pf

R/G

Identified by ACD. On tracing back had been admitted with fever on the 14^th of August to the DGH where the Pakistanis were treated. Malaria blood smear had not been done until informed by AMC HQs. Positive for malaria and treated with ACT on the 21^st of August. However patient developed severe malaria with haematuria. Treated with IV quinine.

6*

M

Pf

R

Identified by ACD. Asymptomatic at the time of diagnosis on the 21^st of August. Admitted to hospital and treated with DOTS.

7*

M

Pf

R

Identified by ACD. Asymptomatic at the time of diagnosis on the 21^st of August. Admitted to hospital but in spite of DOTS developed severe malaria with drowsiness. Treated with IV quinine.

8*

M

Pf

R

Identified by ACD. Asymptomatic at the time of diagnosis on the 22^nd of August. Developed fever following admission. Treated with DOTS.

9*

M

Pf

R

Identified by ACD. Febrile at the time of diagnosis on the 22nd of August. Treated with DOTS.

10

M

Pf

R

Presented to the AMC HQs on the 27^th of December with a history of being diagnosed with falciparum malaria prior to leaving Sierra Leone. Was on anti-malarial treatment (different regime of ACT - not familiar in Sri Lanka). RDT positive/microscopy negative for falciparum malaria when tested at AMC. Diagnosis confirmed by PCR. Treated with ACT and Primaquine.

11

M

Pf

R

Had been screened for malaria by microscopy and RDT on the 27^th of December at AMC HQs and tested negative. Following admission to NHSL^α with fever on the 30^th of December was diagnosed with malaria.

12*

M

Pf

R

Had been screened for malaria by microscopy and RDT on the 27^th of December at AMC HQs and tested negative. At the time of tracing patient was admitted to a Teaching Hospital in the Western Province but had not been tested for malaria. Diagnosed on the 1^st of January 2014.

13*

M

Pf

R

Had been screened for malaria by microscopy and RDT on the 27^th of August at AMC HQs and tested negative. At the time of tracing patient was admitted to a different ward in the same Teaching hospital as patient no. 12 but had not been tested for malaria. Diagnosed with malaria on the 1^st of January 2014.