A cluster of the first reported Plasmodium ovale spp. infections in Peru occuring among returning UN peace-keepers, a review of epidemiology, prevention and diagnostic challenges in nonendemic regions

Table 1 Plasmodium ovale spp. cases

Patient	Service	Age	Episodes P. falciparum (+) in CAR	Primary treatment regimen	Delay in presentation (months)	Presenting complaint	Lab abnormalities	Parasitemia (parasites/µl)	Diagnosis	Treatment regimen
1^a	Navy	44	1	Artemether 80 mg lumefantrine 480 mg	< 1	BP; (F, HA, GF)^a	None	778	PCR microscopy	Chloroquine 250 mg primaquine 30 mg (14 days)
2^b	Army	38	1	Artemether 80 mg lumefantrine 480 mg	11	F, HA, M, A	Th, Tr, IHB	27,339	PCR microscopy	Chloroquine 250 mg primaquine 30 mg (7 days)
3	Army	44	1	Artemether 80 mg lumefantrine 480 mg	11	F, HA, M	Th, Tr, IHB	433	Microscopy	Chloroquine 250 mg primaquine 30 mg (7 days)
4	Army	50	2	Artemether 80 mg lumefantrine 480 mg	11	F, HA, GF, T	Tr	481	Microscopy	Chloroquine 250 mg primaquine 30 mg (7 days)

Delayed presentation time in months from date of return to Peru to seeking care
CAR Central Africa Republic, PCR polymerase chain reaction, BP back pain, F fever, HA headache, M myalgia, A arthralgia, GF general fatigue, T thoracic pain, Th thrombocytopenia, Tr transaminitis, IHB indirect hyperbilirubinemia
^aPatient with P. ovale. curtisi, originally presented with BP 5 days after returning from CAR, symptoms then continued intermittently until April 2017 when diagnosis was made after 2 weeks HA, at 3½ months was admitted with F, BP, M
^bPatient with P. ovale. wallikeri (MIS2712)