Trend analysis of imported malaria in London; observational study 2000 to 2014.


Rees, E; Saavedra-Campos, M; Usdin, M; Anderson, C; Freedman, J; De Burgh, J; Kirkbride, H; Chiodini, P; Smith, V; Blaze, M; Whitty, CJM; Balasegaram, S; (2017) Trend analysis of imported malaria in London; observational study 2000 to 2014. Travel medicine and infectious disease. ISSN 1477-8939 DOI: https://doi.org/10.1016/j.tmaid.2017.04.004

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Abstract

We describe trends of malaria in London (2000-2014) in order to identify preventive opportunities and we estimated the cost of malaria admissions (2009/2010-2014/2015). We identified all cases of malaria, resident in London, reported to the reference laboratory and obtained hospital admissions from Hospital Episode Statistics. The rate of malaria decreased (19.4[2001]-9.1[2014] per 100,000). Males were over-represented (62%). Cases in older age groups increased overtime. The rate was highest amongst people of Black African ethnicity followed by Indian, Pakistani, Bangladeshi ethnicities combined (103.3 and 5.5 per 100,000, respectively). The primary reason for travel was visiting friends and relatives (VFR) in their country of origin (69%), mostly sub-Saharan Africa (92%). The proportion of cases in VFRs increased (32%[2000]-50%[2014]) and those taking chemoprophylaxis decreased (36%[2000]-14%[2014]). The overall case fatality rate was 0.3%. We estimated the average healthcare cost of malaria admissions to be just over £1 million per year. Our study highlighted that people of Black African ethnicity, travelling to sub-Saharan Africa to visit friends and relatives in their country of origin remain the most affected with also a decline in chemoprophylaxis use. Malaria awareness should focus on this group in order to have the biggest impact but may require new approaches.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Infectious and Tropical Diseases
Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Research Centre: Malaria Centre
PubMed ID: 28456684
Web of Science ID: 406180600006
URI: http://researchonline.lshtm.ac.uk/id/eprint/3860798

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