A traveller develops P. falciparum malaria 4 months after returning from East Africa despite having taken mefloquine prophylaxis with documented adher...

Question

A traveller develops P. falciparum malaria 4 months after returning from East Africa despite having taken mefloquine prophylaxis with documented adherence including the 4-week post-travel course. What is the most likely explanation?

Accepted Answer

Late presentation of P. falciparum is extremely unusual beyond 3 months; the diagnosis should be reconfirmed and an alternative source of exposure (e.g., airport malaria, blood transfusion) should be considered

Answer

Mefloquine resistance in East Africa

Answer

Mefloquine never works against P. falciparum

Answer

This is a P. ovale relapse misidentified as P. falciparum

Answer

P. falciparum commonly presents at 4 months

uk-dtmh MCQ (SBA): Delayed P. falciparum Presentation

A traveller develops P. falciparum malaria 4 months after returning from East Africa despite having taken mefloquine prophylaxis with documented adherence including the 4-week post-travel course. What is the most likely explanation?