Screening for Chronic Infectious Diseases by Serology in Those Presenting with Malaria in London, United Kingdom

Alison Gowland Department of Infection, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom

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Emma McGuire Department of Infection, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom

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Anna L. Goodman Department of Infection, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom

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ABSTRACT.

The United Kingdom’s cases of malaria infection are primarily acquired in sub-Saharan Africa, with the majority of infections presenting in London.1 When patients go to a hospital with malaria, there is a screening opportunity for other geographically associated chronic infections. We identified patients who were diagnosed with malaria after presenting to our emergency department in London over a 2-year period, to assess whether there may be clinical benefit in screening for chronic viral (hepatitis B, hepatitis C, HIV) or parasitic (schistosomiasis, strongyloidiasis) infection in this cohort. Over this period, 131 patients were diagnosed with malaria. Crude seropositivity rates for HIV, hepatitis B, and strongyloidiasis were higher than expected compared with local population estimates, 7 and 28 times higher for HIV and hepatitis B, respectively. Those patients with previously unidentified cases were offered appropriate treatment. These findings support the potential clinical and public health benefits of screening for other infectious diseases in the context of a malaria diagnosis.

Author Notes

*Address correspondence to Anna L. Goodman, Guy’s and St. Thomas’ NHS Foundation Trust, Department of Infection, St. Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom. E-mail: anna.goodman@gstt.nhs.uk

Authors’ addresses: Alison Gowland, Emma McGuire, and Anna L. Goodman, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom, E-mails: alison.gowland@nhs.net, emcguire1@nhs.net, and anna.goodman@gstt.nhs.uk.

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