Autochthonous cases of malaria in central Anatolia

Malaria incidence has significantly declined worldwide and Turkey has not been classified as an endemic region since 2016. By 2023, all cases reported in the country were linked to travels to an endemic region. In this report, four cases of malaria caused by Plasmodium falciparum are presented from the province of Kayseri but with no history of travel to any malaria-endemic region. Three cases were diagnosed by reverse transcription-polymerase chain reaction. The second case had mixed parasitemia of P. falciparum and P. vivax. Artemether (20 mg)-lumefantrin were given to all patients. After discharge, the first and fourth malaria cases were admitted with recurrent parasitaemia. They were re-treated and then recovered. The second case improved, but the third case developed organ failure and died. Malaria should be considered in the preliminary clinical diagnosis of patients even when no history of endemic region residence can be verified.