Epidemiologic features impacting the presentation of malaria in children in Houston

Gloria E Oramasionwu1, Susan H Wootton, Morven S Edwards

  • 1Section of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.

Insights

Severe malaria in US children is often linked to vacation travel without proper prophylaxis. Optimizing malaria prevention strategies, especially for travelers, can reduce severe illness in non-endemic areas.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Malaria is diagnosed in US children despite available chemoprophylaxis.
  • Features influencing malaria presentation in non-endemic settings are not well-characterized in pediatric populations.

Purpose of the Study:

  • To characterize the features and risk factors associated with malaria presentation and severity in children diagnosed in a non-endemic setting.

Main Methods:

  • A retrospective chart review of children with confirmed malaria from 1994-2007 at four Houston tertiary hospitals.
  • Analysis included patient demographics, travel history, clinical presentation, and treatment outcomes.

Main Results:

  • Of 104 children, 21% had severe malaria, with US-residing children accounting for 86% of severe cases.
  • Risk factors for severe malaria included vacation travel, female gender, US birth, short travel duration, and delayed presentation.
  • Severe malaria cases presented with more vomiting, hepatomegaly, heart murmur, and higher parasitemia.

Conclusions:

  • Severe malaria in Houston children was associated with travel to endemic regions without adequate prophylaxis.
  • Improving adherence to malaria prophylactic regimens could decrease malaria-related morbidity in non-endemic countries.
Abstract

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