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

Eleanor Rees, Maria Saavedra-Campos, Martine Usdin, Charlotte Anderson, Joanne Freedman, Jane de Burgh, Hilary Kirkbride, Peter Chiodini, Valerie Smith, Marie Blaze, Christopher J.M. Whitty, Sooria Balasegaram

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Background 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). Methods We identified all cases of malaria, resident in London, reported to the reference laboratory and obtained hospital admissions from Hospital Episode Statistics. Results 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. Conclusion 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.

Original languageEnglish
Pages (from-to)35-42
Number of pages8
JournalTravel Medicine and Infectious Disease
Volume17
DOIs
Publication statusPublished - May 2017

Keywords

  • Imported malaria
  • Non-endemic country
  • Travellers
  • VFR

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