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A 33‐year‐old Pakistani man living in Japan developed a fever and headache following a visit to Pakistan and Dubai. Laboratory tests showed thrombocytopenia. The patient could not recall any mosquito bites; however, the malaria rapid diagnostic immune‐chromatographic test (ICT) (BinaxNOW® Malaria, Alere Inc., Waltham, MA) yielded positive results for the control and T2 (Figure 1), indicating infection with Plasmodium vivax, P. ovale, or P. malariae. Malaria parasites were observed in Giemsa‐stained peripheral blood smears (Figure 2). Malaria is not a common disease in Japan, and the number of annual cases of malaria is 48 in Japan in 2016.1 The diagnostic accuracy of Giemsa‐stained peripheral blood smears is significantly affected by the staining techniques used and the skill of the technician.2 ICT enables a more rapid and easier diagnosis of malaria and is completed in 15 minutes. Moreover, P. falciparum, which can cause severe symptoms and death, can be differentiated from other types of malaria parasites using ICT. If ICT yielded positive results for the control and T2 (Figure 1) as this case, differentiation of P. vivax and P. ovale is difficult, even if the examiner has enough experiences. However, it is possible to differentiate P. vivax and P. ovale by considering their infected area because their endemic area is different.
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
Kashihara N, Iwamuro M, Kusano N, Otsuka F. Rapid laboratory tests for malaria detection in Japan. J Gen Fam Med. 2017;18:470–471. https://doi.org/10.1002/jgf2.119