Trends in imported childhood malaria in the UK:1999-2003

Abstract

Although the incidence of malaria has started to decline, a considerable number of children are still diagnosed with malaria in the UK. In addition, the proportion of children with malaria who had taken malaria prophylaxis is falling. Although it is reassuring to note the low mortality, there is an urgent need to improve preventive measures among families travelling to high-risk countries.

Risk Factors for Severe Disease in Adults with Falciparum Malaria

“…A reduced hemoglobin level and platelet count and a raised WBC count were associated with severity. A 1-U increase in WBC count ( cells/L, or 1000 cells/mL) in- 9 1 ϫ 10 creased the odds of severe falciparum malaria by 39%.…”

“…Such studies can provide valuable information on a population group not complicated by other confounding factors, such as malnutrition, immunosuppression, and multiple pathologies. Those studies in travelers that have been published either have largely focused on demographic factors [2][3][4], subgroups of patients (e.g., those with malaria due to different parasite species) [5,6], mild disease [7], severe disease alone [8], or children [9] or have been relatively small [10][11][12]. Studies in malaria-nonendemic regions provide a unique opportunity to examine the risk of severe disease in individuals of different ethnic backgrounds and relative to previous exposure.…”

Imported childhood malaria: the Dublin experience, 1999–2006

“…It suggests that imported childhood malaria in Dublin is still relatively uncommon, accounting for only 58 hospital admissions over the 8-year period surveyed. These numbers are small in comparison to figures from France and the UK [3]. With an established African community now resident in Dublin, we can expect to see the incidence increasing in the coming years.…”

“…This has been attributed to a global increase in long-distance travel, increased population movement and resurgence of malaria in many tropical countries [2]. Approximately, 15% of cases occur in the paediatric population [3]. Ireland now has a substantial population of immigrants from malaria-endemic regions.…”

UK treatment of malaria

“…In Europe, the UK has one of the highest burdens of imported malaria with cases peaking in 1995 at 2500 cases followed by a gradual fall to 1370 cases in 2008 5. Children account for 15–20% of all cases and the estimated burden of imported malaria in the UK is 2.8/100 000 children, with P falciparum accounting for over 80% of childhood cases 6 7. Over 90% of all imported malaria cases in the UK occurred among black African children, who acquired their infection in Africa while visiting friends and relatives (so-called VFR) 8.…”