This article is more than 5 years old. Information may no longer be current.
Most imported malaria cases in United Kingdom, Ireland included children who traveled without prophylaxis
Click Here to Manage Email Alerts
Most imported childhood malaria cases in the United Kingdom and Ireland during 2006-2007 included African children who traveled to West Africa without antimalarial prophylaxis, indicating a need to educate families on malaria prevention, U.K. researchers reported.
In a prospective, population-based study, researchers investigated the epidemiology and clinical features of imported malaria in children aged younger than 16. The researchers performed prospective national surveillance and clinical data collection using the British Pediatric Surveillance Unit and performed a capture-recapture analysis using cases that were independently reported to national surveillance centers.
Researchers noted 290 cases, 186 of which were reported through the British Pediatric Surveillance Unit along with clinical details. Capture-recapture analysis revealed case estimates of 2.8 per 100,000 per year for the United Kingdom and 4.6 per 100,000 per year for Ireland.
Epidemiologic data were available for 172 cases identified through the British Pediatric Surveillance Unit and for 118 cases not identified through the surveillance unit. Median age at diagnosis was 8 years. Data on where the disease was acquired were available for 262 cases and revealed that 90% were acquired in Africa, specifically West Africa (79%), with the remaining 10% acquired in the Indian Subcontinent.
Twenty-six percent of children who had traveled to a malaria-endemic country had been previously diagnosed with malaria.
“[This finding] is concerning because it suggests that these children continue to travel without appropriate precautions and reflects missed opportunities by clinicians to educate families on malaria prevention,” the researchers wrote.
Of the 172 cases from the surveillance unit, 117 were travelers and 55 were visitors, 85% of whom were from West Africa. Sixty-one percent of travelers who acquired malaria had not taken antimalarial prophylaxis and 8% did take appropriate prophylaxis, the researchers reported. Antimalarial regimen was not specified for 17% of these cases.
Of 148 children who acquired Plasmodium falciparum malaria, one-third met WHO criteria for severe or potentially complicated malaria. However, only 24% of those who met these criteria required intensive care.
The researchers reported that antimalarials varied “considerably” both within and between hospitals. Recurrence occurred in one child, and none of the children died.
“Interventions to prevent imported childhood malaria should focus on black-African families traveling to West Africa, while pediatricians should be offered clearer guidance on the treatment of childhood malaria,” the researchers wrote. “It is … imperative that national guidelines are precise in their recommendations and smaller hospitals have access to specialist pediatric infectious disease units for advice and assistance in managing complicated cases.”
Ladhani S. Pediatr Infect Dis J. 2010;29(5):434-438.