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Malaria in children in Chicago
B Emanuel1, N Aronson, S Shulman
1Department of Pediatrics, Northwestern University Medical School, Chicago, IL.
Insights
Pediatric malaria cases are rising due to immigration and travel. Early diagnosis and prompt treatment are crucial for febrile children, especially those with splenomegaly, to prevent severe illness.
Area of Science:
- Pediatric infectious diseases
- Tropical medicine
- Epidemiology of parasitic diseases
Background:
- Malaria diagnosis in children presents challenges in non-endemic regions.
- Increased global travel and immigration contribute to imported pediatric malaria cases.
- Delayed diagnosis can lead to prolonged hospitalization and suboptimal outcomes.
Purpose of the Study:
- To review the clinical experience of diagnosing childhood malaria in Chicago hospitals.
- To identify factors contributing to delayed diagnosis and treatment of pediatric malaria.
- To inform healthcare providers about the increasing incidence of pediatric malaria.
Main Methods:
- Retrospective medical record review.
- Analysis of pediatric cases diagnosed with malaria between 1985 and 1990.
- Inclusion of data from a large children's hospital and two community hospitals.
Main Results:
- Twenty cases of pediatric malaria were identified over a 6-year period.
- Commonly misdiagnosed conditions included malignancy, typhoid fever, appendicitis, and UTIs.
- Delayed diagnosis was often linked to failure to elicit travel or immigration history early.
Conclusions:
- Pediatricians must maintain a high index of suspicion for malaria in febrile children, particularly those with immigration or travel history.
- Antimalarial prophylaxis education for families traveling to endemic areas is essential.
- Prompt recognition and treatment are vital for improving outcomes in childhood malaria.
Objective:
To review the experience of a large children's hospital and two community hospitals in Chicago in which malaria was diagnosed in children during a recent 6-year period.
Methods:
Retrospective medical record review covering the years 1985 to 1990.
Results:
Twenty cases of childhood malaria were diagnosed, generally in patients hospitalized for fever unresponsive to oral antibiotics also associated with splenomegaly, with presumptive diagnoses of malignancy, typhoid fever, acute appendicitis, or urinary tract infection. History of recent immigration to the United States or travel to a malaria-endemic area was frequently not elicited until several days into hospitalization, thus delaying diagnosis and therapy.
Conclusions:
Because malaria in the United States pediatric population has increased as a result of foreign immigration and overseas travel, pediatricians must be alert to the possibility of malaria in febrile children, and the importance of antimalarial prophylaxis should be communicated to parents of children traveling to endemic areas.