A portion of this research was presented in poster format at the 2008 meeting of the American Society of Tropical Medicine and Hygiene.
A Local, Regional, and National Assessment of Pediatric Malaria in the United States
Article first published online: 11 APR 2011
© 2011 International Society of Travel Medicine
Journal of Travel Medicine
Volume 18, Issue 3, pages 153–160, May/June 2011
How to Cite
Hickey, P. W., Cape, K. E., Masuoka, P., Campos, J. M., Pastor, W., Wong, E. C. and Singh, N. (2011), A Local, Regional, and National Assessment of Pediatric Malaria in the United States. Journal of Travel Medicine, 18: 153–160. doi: 10.1111/j.1708-8305.2011.00514.x
- Issue published online: 3 MAY 2011
- Article first published online: 11 APR 2011
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.