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Malaria in Children at 9 US Hospitals: 2016-2023
Sesh Alexander Sundararaman1, Brianne Roper1,2, Amy K F Davis3
1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Insights
Delayed diagnosis of imported pediatric malaria in the US is common, increasing severe disease risk. Prompt diagnosis and chemoprophylaxis are vital for better outcomes in children.
Area of Science:
- Infectious Diseases
- Global Health
- Pediatrics
Background:
- Imported pediatric malaria presents a public health challenge in non-endemic regions.
- Understanding trends and risk factors is crucial for effective management.
Purpose of the Study:
- To describe imported pediatric malaria cases in the US from 2016-2023.
- To identify patient demographics, clinical outcomes, and risk factors for severe disease.
Main Methods:
- Retrospective descriptive study.
- Analysis of 171 pediatric malaria cases from 9 US hospitals (2016-2023).
- Evaluation of patient demographics, symptoms, and diagnostic timelines.
Main Results:
- Most cases involved travel to West Africa; fever and abdominal symptoms were common.
- 32% of children had severe malaria.
- Delayed diagnosis (26%) was frequent and a significant risk factor for severe outcomes.
Conclusions:
- Delayed diagnosis of imported pediatric malaria is a critical issue in the US.
- Prompt diagnosis and malaria chemoprophylaxis are essential for reducing morbidity and improving patient outcomes.
Objectives:
This study set out to describe imported pediatric malaria in the United States over an 8-year period, including patient demographics, clinical outcomes, and risk factors for severe disease.
Methods:
A retrospective descriptive study of pediatric patients treated for malaria at 9 hospitals in the United States from 2016 to 2023 was conducted to analyze patient demographics, clinical outcomes, and risk factors for severe malaria.
Results:
A total of 171 children were treated across the 9 US hospitals included in this study from 2016 to 2023. Most patients had traveled to West Africa to visit friends and relatives. Fever was the most common symptom recorded (90%), and most reported at least 1 abdominal symptom (66%). Thirty-two percent of patients were diagnosed with severe malaria. No deaths occurred. Delayed diagnoses were common (26%), occurred at similar rates across all hospitals in the study, and were a risk factor for severe malaria.
Conclusions:
Delayed diagnoses of travel-acquired malaria were common for pediatric patients presenting to hospitals in the United States and are associated with higher risk for severe malaria, which is associated with longer hospitalizations and increased morbidity. Chemoprophylaxis against travel-acquired malaria and prompt diagnosis of imported cases are crucial to improving patient outcomes.
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