A Case Report of Serological Rapid Diagnostic Test-Negative Plasmodium malariae Malaria Imported from West Africa.

Background: The imported cases of Plasmodium malariae (P. malariae) and Plasmodium ovale (P. ovale) malaria are increasing annually, especially in central China. Here, we report a case of serological rapid diagnostic test (RDT)-negative P. malariae malaria imported from West Africa. Methods: The case patient was exclusively diagnosed with P. malariae through microscopy, Plasmodium genusspecific nested polymerase chain reaction (PCR), and sequencing of targeted P. malariae circumsporozoite (pmcsp) gene, except for serological RDT. Results: The patient was discharged in stable condition after 5 days of hospitalization, with no overt malaria parasites or associated symptoms. Conclusions: This case reveals that asymptomatic P. malariae infections can occur among exported laborers back from malaria-endemic areas, some of whom may escape serological screening test or RDT, posing a continuing potential threat to malaria control. Therefore, PCR-based molecular techniques are more effective and necessary than serological RDT for malaria surveillance nationwide. [ABSTRACT FROM AUTHOR]