Occurrence of imported malaria in Parma, Northern Italy, during the period 2000-2006 by comparing microscopy and molecular methods

objectives Malaria is the most common imported infection in Italy because of increasing of population movements from endemic countries (Romi et al., 2002) . Our study aimed to describe the occurrence of imported malaria in Parma, Northern Italy, during the period 2000–2006 comparing the data obtained with microscopic observation and molecular methods (Nested-PCR and Realtime PCR). methods Blood samples were collected on admission from 639 patients presenting to Parma University Hospital with symptoms consistent with malaria between January 2000 and December 2006. Samples were submitted to immunochromatographic rapid assay, microscopy (orange acridine and Giemsa stain) and 6 different PCR assays (NP-1993, NP-2002, NP-2004, NP-2005, RT-2004P and RT-2004R) (Snounou et al., 1993-2002; Ndao et al., 2004; Calderaro et al., 2007; Perandin et al., 2004; Rougemont et al., 2004) . results One hundred forty-two cases of malaria were diagnosed by microscopy (118 P. falciparum, 7 P. ovale, 10 P. vivax, 5 P. spp., 1 Pf/P. spp. and 1 mixed infections) and 147 by PCRs (118 P. falciparum, 14 P. ovale, 6 P. vivax, 3 P. malariae and 6 mixed infections). One hundred thirty-four patients were foreigners or tourists coming from Africa, 2 from Indonesia and 10 patients were from unknown country of origin or visit. Most of patientshad no chemoprophylaxis and presented relevant specific clinical symptoms and signs for malaria (such as fever, headache). conclusion Our data confirm that the most prevalent malaria cases in Italy were imported from Africa and were due to P. falciparum (80.2% of cases). PCRs revealed a major number of P. ovale and mixed infections respect to microscopy, followed by P. vivax and P. malariae infections. Despite microscopy remains the first diagnostic method, we observed that in some cases molecular assays are the only ones allowing a diagnosis, in particular to detect species other than P. falciparum and mixed infections.