The delayed diagnosis of travel-acquired malaria in children treated at US hospitals is a significant concern, revealing a higher risk of severe disease. A recent study published in Pediatrics examined 171 pediatric cases from 2016 to 2023 across nine hospitals and found that one-third of children developed severe malaria, although no deaths were reported.
Key findings include:
- Delayed Diagnosis: About 26% of children had prior healthcare encounters where malaria was neither considered nor tested for. Among those with delayed diagnoses, 51% developed severe malaria.
- Travel History: Most children (73%) had traveled to West Africa, often to visit relatives. Symptoms typically included fever (90%) and gastrointestinal issues (66%).
- Misdiagnosis: Children were often misdiagnosed with viral infections, strep throat, or gastroenteritis before malaria was correctly identified. The median delay in diagnosis was three days.
- Preventive Measures: Fewer than half (46%) of travelers sought pretravel counseling. Among those who received malaria prophylaxis, only 11% adhered to the medication schedule, often due to barriers like medication availability and insurance approval.
The study emphasizes the need for healthcare providers to maintain a high suspicion of malaria in patients with recent travel to endemic regions and highlights the importance of rapid testing and effective preventive measures. The results underscore ongoing risks malaria poses to child travelers and the critical need for prompt diagnosis and treatment.
