# Alert for Imported Malaria in Non-Endemic Areas: A Case Report of Atypical Falciparum Malaria in a Young Child and Diagnostic Experience

## TL;DR

A young child with atypical malaria symptoms was correctly diagnosed using a structured approach, highlighting the importance of considering travel history in non-endemic areas.

## Contribution

The paper introduces a practical diagnostic framework for atypical pediatric imported malaria cases in non-endemic regions.

## Key findings

- A 2-year-11-month-old child with fever and diarrhea was diagnosed with Plasmodium falciparum malaria after returning from Sudan.
- The diagnosis was confirmed using rapid diagnostic testing and microscopic examination, guided by the patient's travel history.
- The case illustrates a closed-loop model for early detection of atypical pediatric imported malaria.

## Abstract

Background: Although China has eliminated indigenous malaria, imported cases, particularly among young and middle-aged workers returning from Africa, constitute a major challenge for current epidemic prevention and control. In contrast, imported malaria in children is extremely rare and often subject to diagnostic delays in non-endemic areas due to atypical clinical presentations. Case presentation: We report a case of a 2-year-11-month-old boy who returned from Sudan, a malaria-endemic region, presenting with fever and diarrhea as the initial symptoms. The case was identified by the laboratory through the blood routine re-examination rules, crucially informed by the patient’s epidemiological history. The diagnosis was ultimately confirmed as Plasmodium falciparum malaria by rapid diagnostic testing and microscopic examination. Conclusion: This diagnostic pathway exemplifies a closed-loop model of “clinical suspicion → targeted laboratory testing → definitive pathogen identification.” It provides a practical framework for the early detection and diagnosis of pediatric imported malaria with atypical presentations in non-endemic areas.