|
Malaria |
|
Many Malaria
Deaths Preventable PHILADELPHIA: A new
study finds that most malaria deaths among U.S.
travelers between 1963 and 2001 were preventable.
The study is published in the Oct. 5, 2004, issue
of Annals of Internal Medicine, a peer-reviewed
medical journal published in Philadelphia by the
American College of Physicians. Although indigenous
transmission of malaria was eradicated from the
United States in the late 1940s, every year about
1,500 malaria cases occur in the United States.
Most infections occur in people who travel abroad,
and one of every 100 U.S. travelers with diagnosed
malaria die. Researchers at the
Centers for Disease Control and Prevention (CDC)
reviewed records of U.S. travelers who died of
malaria between 1963 and 2001. Of 123 deaths, most
(105 people or 85.4 percent) were considered
preventable. For 83 of these,
the patient‚s own actions may have contributed
to death. The factors that contributed to death
included not taking necessary preventive medicines;
not following the prescribed regimen for the
medications, or not seeking medical attention
promptly (within two days) when symptoms
occurred. For 70 of the 105
deaths (66.7 percent), medical errors may have
contributed to the deaths. Among these errors were
clinicians not prescribing the correct preventive
medicines; not diagnosing malaria when the patient
first reported symptoms; not beginning treatment
promptly after diagnosis, or not treating the
patient with the appropriate antimalarial
drug. Robert D. Newman,
MD, MPH, lead author of the CDC study, says,
„Health care providers need to know that the
CDC has expanded resources available that provide
critical up-to-date information regarding
prevention and treatment of malaria. Dr. Newman
encourages travelers and physicians providing
pre-travel advice to access the CDC Travelers‚
Health Web site at http://www.cdc.gov/travel This
resource emphasizes the importance of taking
preventive drugs appropriate to the area of travel;
describes other measures to protect against
malaria; and guides travelers through developing a
plan for illness, abroad or after return to the
United States, including reporting any symptoms and
travel history to physicians promptly. Newman urges
physicians to take a travel history in a febrile
patient, obtain a blood film for suspected malaria,
and use malaria management advice available through
the CDC Malaria Hotline (770-488-7788), which
provides access to CDC malaria experts 24 hours a
day, 365 days a year. Continuously updated
information for health providers on treatment of
malaria is also available online at
http://www.cdc.gov/malaria. Another critical
element of managing a patient with malaria is
access to the proper treatment drug. Dr. Newman
notes that „(h)ospitals must have intravenous
quinidine gluconate on hospital formulary because
it is the only drug currently approved and
available in the United States for treating severe
malaria. Annals of Internal
Medicine is published in Philadelphia by the
American College of Physicians, the largest
medical-specialty organization and second-largest
physician group in the United States. ACP members
include more than 116,000 internal medicine
physicians (internists), related subspecialists,
and medical students. Internists specialize in the
prevention, detection and treatment of illnesses in
adults, reflected in the organization's trademarked
phrase Doctors of Internal Medicine. Doctors for
Adults.® For embargoed
copies of the article, „Malaria-related Deaths
among U.S. Travelers, 1963-2001,‰ please call
Penny Fuller, American College of Physicians,
1-800-523-1546, ext. 2653;
pfuller@acponline.org To set up an
interview with Dr. Robert D. Newman, CDR, U.S.
Public Health Service, Medical Officer, Centers for
Disease Control and Prevention (CDC) Malaria
Branch, call Jennifer Morcone at
404-867-7493. Leigh
Fazzina Senior
Communications Associate American College of
Physicians 190 N. Independence
Mall West Philadelphia, PA
19106 215-351-2514
(p) |
