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Childhood malaria in East London
Shamez Ladhani1, Haithim El Bashir, Vidya S Patel
1Department of Pediatrics, Newham General Hospital, Queen Mary's School of Medicine and Dentistry, London, UK.
Insights
Most pediatric malaria cases in East London involved UK-born children of Black African ethnicity visiting family abroad. While many took prophylaxis, few followed guidelines, yet most cases were uncomplicated and responded well to treatment.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology of Malaria
- Global Health
Background:
- Malaria remains a significant concern, even in non-endemic regions like East London, primarily affecting children.
- Understanding the specific demographic and clinical features of pediatric malaria cases is crucial for effective public health strategies.
Purpose of the Study:
- To characterize the epidemiological, clinical, and laboratory profiles of children under 16 diagnosed with malaria in East London.
- To identify risk factors and patterns of malaria acquisition in a pediatric population in a non-endemic urban setting.
Main Methods:
- A retrospective case review was conducted on children admitted to two East London hospitals between 1996 and 2001.
- Data were collected through hospital discharge records and malaria notification systems.
Main Results:
- 211 pediatric malaria cases were identified, with a median age of 9 years. 82% acquired malaria during travel to endemic countries, predominantly Plasmodium falciparum from Africa.
- The majority of affected children were UK-born, of Black African ethnicity, and traveled to visit family. Peak incidence occurred in late summer/early autumn.
- Despite 42% receiving antimalarial prophylaxis, only 15% adhered to guidelines. Severe malaria occurred in 7.1% of cases, with concurrent malaria found in siblings in 23% of instances.
Conclusions:
- Pediatric malaria in East London is largely imported by UK-born children of Black African descent visiting family in malaria-endemic regions.
- Most cases presented with uncomplicated malaria and responded well to treatment, though adherence to prophylaxis was suboptimal.
- The findings highlight the importance of targeted prevention advice for families traveling to malaria-endemic areas.
Objectives:
To describe the epidemiologic, clinical and laboratory features of children younger than 16 years with malaria in East London.
Methods:
Retrospective case review of all children admitted to two East London hospitals with malaria identified between 1996 and 2001 with the use of notifications and hospital discharge data.
Results:
A total of 211 children with a median age of 9 years (range, 11 to 179 months) were identified. Children living in the UK who acquired malaria while visiting a malaria-endemic country on holiday accounted for 82% of cases, whereas the rest were children visiting the UK from endemic areas. Three-fourths of children who had traveled to a malaria-endemic area were born in the UK, and 93% were of Black African ethnicity. The peak seasonal incidence was late summer/early autumn. Plasmodium falciparum acquired in Africa accounted for 91% of cases. Although 42% of children took antimalarial prophylaxis, only 15% of medications were taken according to recommended guidelines. Another family member, most often a sibling, was found to have concurrent malaria in 23% (49 of 211) of cases. On the basis of the WHO criteria, 15 children (7.1%) 15 months to 15 years of age had severe malaria, including convulsions (n = 4), acute renal failure (n = 3), jaundice (n = 4), severe anemia (n = 3) and >2% parasitemia (n = 6).
Conclusions:
The majority of children with malaria in this study were UK-born, school age, of Black African ethnicity and were visiting family in Africa, often with other family members. Most children had low level parasitemia and uncomplicated malaria, and they responded rapidly to antimalarial treatment.
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