Journal of Travel Medicine
Volume 18, Issue 3, 2011, Pages 153-160

A local, regional, and national assessment of pediatric malaria in the United States (Article) (Open Access)

Hickey P.W. , Cape K.E. , Masuoka P. , Campos J.M. , Pastor W. , Wong E.C. , Singh N.*
  • a Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD, United States, Department of Pediatrics, Uniformed Services University, Bethesda, MD, United States
  • b Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC, United States
  • c Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD, United States
  • d Department of Laboratory Medicine, Children's National Medical Center, Washington, DC, United States, Departments of Pediatrics, Pathology and Microbiology/Immunology/Tropical Medicine, George Washington University Medical Center, Washington, DC, United States
  • e Clinical Operations, Children's National Medical Center, Washington, DC, United States
  • f Department of Laboratory Medicine, Children's National Medical Center, Washington, DC, United States
  • g Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC, United States, Division of Infectious Disease, Children's National Medical Center, 111 Michigan Ave., N.W, Washington, DC 20010, United States, Department of Pediatrics, George Washington University School of Medicine, Washington, DC, United States

Abstract

Background. Imported malaria remains a public health concern in the United States, but the health impact on children and the financial costs to society have not been well defined. Methods. Inpatient and outpatient malaria cases diagnosed at Children's National Medical Center (CNMC) in Washington, DC over an 8-year period are retrospectively reviewed. Cases are mapped against Census Bureau population data. These observations are compared with the national burden of pediatric malaria, including both disease severity and cost, by reviewing inpatient malaria cases in the Pediatric Health Information System (PHIS), January 2003 to June 2008. Results. At CNMC, malaria most commonly affects children who traveled to West Africa to visit friends and relatives. Poor adherence to prophylaxis and self-treatment with antimalarial medications were commonly identified.Mapping demonstrates case clustering in communities with large sub-Saharan African populations. The cumulative incidence (CI) of malaria at CNMC of 9.0 per 10,000 admissions is 7.6 times the national average. The CI of malaria at PHIS hospitals is 1.2 per 10,000 admissions with an average cost of $17,519. Conclusions. Malaria is a preventable disease for which the risk to life and costs of treatment are significant. Patterns of risk can be used by health planners to target prevention strategies at the community level. In regions with a high density of immigrants, particularly from sub-Saharan Africa, physicians must be aware of the risk, understand recommended prophylaxis and treatment regimens, and advocate for their appropriate use in the community. © 2011 International Society of Travel Medicine.

Author Keywords

[No Keywords available]

Index Keywords

hospital admission Hospitals, Pediatric human clinical assessment District of Columbia Malaria Databases, Factual pediatrics pyrimethamine plus sulfadoxine United States health care cost Health Care Costs school child Humans azithromycin Adolescent Infant, Newborn Antimalarials male preschool child female Infant Child, Preschool Africa medical information system Incidence Article Retrospective Studies prophylaxis major clinical study adult malaria falciparum Censuses disease severity Patient Acceptance of Health Care Analysis of Variance retrospective study chloroquine Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-79955706004&doi=10.1111%2fj.1708-8305.2011.00514.x&partnerID=40&md5=4cf92e00f17c185f23f3014bb87d658d
DOI: 10.1111/j.1708-8305.2011.00514.x
ISSN: 11951982
Cited by: 9
Original Language: English