J P Williams1, M Chitre, M Sharland. 1. Department of Haematology, St George's Hospital, Blackshaw Road, London SW17 OQT, UK.
Abstract
AIMS: To identify changes in the presenting number and species of imported malaria in children in southwest London. METHODS: A prospective single observer study over 25 years (1975-99) of all cases of paediatric malaria seen at St George's Hospital. RESULTS: A confirmed diagnosis was made in 249 children (56% boys; 44% girls; median age 8.0 years). Of these, 53% were UK residents and 44% were children travelling to the UK. A significant increase was noted in the number of cases over the 25 years (1975-79: mean 4.8 cases/year; 1990-99: mean 13.7 cases/year). Over the 25 years Plasmodium falciparum was seen in 77%, P vivax in 14%, P ovale in 6%, and P malariae in 3% of cases. P falciparum had increased in frequency (1975-79: P falciparum 50%, P vivax 50%; 1990-99: P falciparum 82%, P vivax 6%), associated with an increase in the proportion of children acquiring their infection in sub-Saharan Africa. Median time between arrival in the UK to the onset of fever was: P falciparum, 5 days; P ovale, 25 days; P malariae, 37 days; and P vivax, 62 days. Median time interval between the onset of fever to commencement of treatment was 4 days. This had not improved over the 25 year period. Only 41% of UK resident children presenting to hospital had taken prophylaxis and the overall number of symptomatic children taking no prophylaxis was increasing. CONCLUSION: Imported childhood P falciparum malaria is increasing in southwest London associated with increasing travel from sub-Saharan Africa. Over the 25 year period there has been no improvement in chemoprophylaxis rates or time to diagnosis.
AIMS: To identify changes in the presenting number and species of imported malaria in children in southwest London. METHODS: A prospective single observer study over 25 years (1975-99) of all cases of paediatric malaria seen at St George's Hospital. RESULTS: A confirmed diagnosis was made in 249 children (56% boys; 44% girls; median age 8.0 years). Of these, 53% were UK residents and 44% were children travelling to the UK. A significant increase was noted in the number of cases over the 25 years (1975-79: mean 4.8 cases/year; 1990-99: mean 13.7 cases/year). Over the 25 years Plasmodium falciparum was seen in 77%, P vivax in 14%, P ovale in 6%, and P malariae in 3% of cases. P falciparum had increased in frequency (1975-79: P falciparum 50%, P vivax 50%; 1990-99: P falciparum 82%, P vivax 6%), associated with an increase in the proportion of children acquiring their infection in sub-Saharan Africa. Median time between arrival in the UK to the onset of fever was: P falciparum, 5 days; P ovale, 25 days; P malariae, 37 days; and P vivax, 62 days. Median time interval between the onset of fever to commencement of treatment was 4 days. This had not improved over the 25 year period. Only 41% of UK resident children presenting to hospital had taken prophylaxis and the overall number of symptomatic children taking no prophylaxis was increasing. CONCLUSION: Imported childhood P falciparum malaria is increasing in southwest London associated with increasing travel from sub-Saharan Africa. Over the 25 year period there has been no improvement in chemoprophylaxis rates or time to diagnosis.
Authors: Momar Ndao; Etienne Bandyayera; Evelyne Kokoskin; David Diemert; Theresa W Gyorkos; J Dick MacLean; Ron St John; Brian J Ward Journal: CMAJ Date: 2005-01-04 Impact factor: 8.262
Authors: M Chalumeau; L Holvoet; G Chéron; P Minodier; L Foix-L'Hélias; P Ovetchkine; F Moulin; V Nouyrigat; G Bréart; D Gendrel Journal: Eur J Clin Microbiol Infect Dis Date: 2006-03 Impact factor: 3.267