Multidisciplinary Approach of a Male Case of Imported Malaria, HIV Chronic Infection, and Latent Syphilis.

Background: The current economic and social crisis in Latin America has caused migration to the USA, bringing with it Public Health challenges due to the importation of various infectious diseases. Migrants, particularly those with chronic conditions, such as HIV infection and other sexually transmitted infections (STI), are at greater risk due to pharmacological interruption and access to medical care, so the timely detection of diseases acquired during their migration, such as malaria, is crucial to avoid health complications.

Objective: To outline by a multidisciplinary approach (Infectology, Parasitology, Epidemiology, molecular Biology, Venereology, and Public Health) the diagnosis and management of a male case with malaria imported to Mexican territory, HIV chronic infection, and latent syphilis.

Methods: A male migrant of Venezuelan nationality attended the Clínica Especializada Condesa Iztapalapa in Mexico City for health complications. A comprehensive analysis of laboratory and molecular tests was performed to confirm HIV infection. During the STI diagnostic algorithm, latent syphilis was detected and microscopic observation of blood smears revealed parasitic forms compatible with malaria. Standard and molecular tests were applied under the operational definition for malaria cases for identification, diagnosis, and treatment. Finally, study of clinical history and migration route by questioning for the investigation of the imported case was performed.

Results: The immigrant was diagnosed with HIV chronic-stage infection with interrupted antiretroviral therapy (ART), latent syphilis, and malaria by Plasmodium vivax. The ART administered was chosen based on the possible drug interaction with antimalarials and genetic barrier to the HLA-B* allele. Finally, antimicrobial therapy against syphilis was penicillin. From the analysis of the migratory route, incubation time of imported malaria, and questioning, we speculated that the migrant acquired the P. vivax infection in Panama.

Conclusions: This case highlights the complex health problems faced by migrants with HIV infection, particularly when they contract additional infections such as malaria during migration and highlights the need for comprehensive access to healthcare and ART, antimalarial and antimicrobial treatments to mitigate the health risks of this vulnerable population.