Most U.S. malaria deaths could have been prevented

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Most of the people who die of malaria in the U.S. probably wouldn’t have died if they had taken preventive medicines properly, or received earlier diagnosis or treatment, according to new research from the U.S. Centers for Disease Control and Prevention.

Virtually all of the 1,500 cases of malaria seen each year in the U.S. are contracted elsewhere in the world, and about 1 percent of these cases are fatal.

"Errors on the part of the traveler or the healthcare provider or both appear to have contributed to nearly every death,” study author Dr. Robert D. Newman told Reuters Health.

For instance, although malaria can be prevented with medications, less than 6 percent of the people who died appeared to have taken the appropriate drug consistently and correctly while visiting infected areas.

Everyone traveling to an area with malaria should visit a healthcare provider between 4 and 6 weeks before they leave, to ensure they take the right steps to prevent illness, Newman said. And in case these precautions are not enough, travelers should also prepare for how to handle malaria if it occurs, he added.

“Travelers should plan in advance what they would do in case of illness abroad or after return to the United States,” Newman said. “This includes reporting promptly any symptoms, together with their history of travel to a malaria risk area, to healthcare providers.”

In the year 2000 alone, almost 28 million Americans visited countries where there is malaria.

Newman and his team reviewed the medical records of 185 people who died of malaria between 1963 and 2001 in the U.S. More than two-thirds were American travelers, mostly to Africa. The countries that produced the most fatal infections included Kenya, Nigeria and Liberia.

In most cases, people infected with malaria first developed a fever and chills. Half of those who died showed signs of the disease within 5 days after they returned to the U.S., but some developed their first symptoms up to 4 years later.

Although time is of the essence when treating malaria, half of malaria victims waited at least 5 days after they developed symptoms before going to the doctor, the authors report in the Annals of Internal Medicine. Nearly 20 percent were first diagnosed with the disease during their autopsies.

Almost half of the people who died did not take any anti-malaria medicine during their visits to infected countries. Among those who did take drugs, more than one-third took medications that were not suitable for the region they were visiting.

And 30 percent of the people given the right drugs did not take them correctly, Newman and his team report.

Overall, they conclude, approximately 85 percent of these malaria deaths could have been prevented.

SOURCE: Annals of Internal Medicine, October 5, 2004.

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