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768. Malaria in a Non-Endemic Setting: A Retrospective Review of Malaria Hospitalisations in Ireland over a Four Year Period
Author(s) -
David Moynan,
Niamh Reidy,
James O’Connell,
Paul T. Reidy,
Eoghan de Barra
Publication year - 2020
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofaa439.958
Subject(s) - medicine , malaria , plasmodium vivax , retrospective cohort study , pediatrics , plasmodium malariae , population , plasmodium ovale , incidence (geometry) , plasmodium falciparum , demography , environmental health , immunology , physics , sociology , optics
Background With globalisation fuelling the fire for infectious diseases, it’s important for general physicians to be aware of the tropical infections presenting to hospitals. Malaria, with over 400,000 deaths annually worldwide, has an Irish notification rate of 1.2 per 100,000 of the population, the seventh highest incidence rate of imported malaria globally. This analysis aims to examine the demographics and outcomes of Irish patients with malaria over a four year period. Methods A retrospective analysis of all patients with malaria admitted to Irish hospitals between January 1st 2016 and December 31st 2019 was performed. Data was obtained from the National Quality Assurance Improvement System (NQAIS), a national electronic database that collates data from hospital admissions. This was analysed using STATA. Patient demographics, hospital length of stay and documented malaria subspecies are described. Results Between January 1st 2016 and December 31st 2019 there were 289 cases of malaria admitted to Irish hospitals, 13/289 (4.5%) requiring high dependency care. 197/289 (68%) were male. The mean age was 35 years (95% CI 33.3 – 37). 220/289 (76%) of all cases resulted from Plasmodium falciparum infection, 16/289 (5.5%) Plasmodium ovale, 11/289 (3.8%) Plasmodium vivax and 2/289 (0.7%) Plasmodium malariae, while 40/289 (13.8%) were unspecified. The median length of stay was 3 days (IQR 1-4 days) and 72/289 (25%) were admitted under an Infectious Diseases team, although this had no significant impact in length of stay (3.1 days versus 3.4 days, p=0.68). 117/289 (40%) were admitted in the months of August and September. There were no reported deaths. Conclusion This report gives a clinical context to the 2016 – 2019 NQAIS data, particularly with regards to inpatient length of stay, malaria species diagnosed and numbers requiring critical care. The majority of all cases in the four year period were P. falciparum, reflective of the dominant African region of exposure in most cases. Interestingly, 43% of all cases were from hospitals outside of the Dublin City catchment area, reflecting a diversification of travel and population demographics in Ireland. This highlights the importance of malaria awareness in all regions in Ireland, not simply the major urban centres. Disclosures All Authors: No reported disclosures

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