Malaria-Related Hospitalizations in the United States, 2000–2014

Diana Khuu Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California;
Research, Epidemiology, and Evaluation Unit, Clinical Services and Research Branch, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, Alhambra, California;

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Mark L. Eberhard Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Benjamin N. Bristow Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California;

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Marjan Javanbakht Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California;

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Lawrence R. Ash Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California;

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Shira C. Shafir Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California;
TOMS Shoes, LLC, Los Angeles, California

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Frank J. Sorvillo Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California;

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DOI:
https://doi.org/10.4269/ajtmh.17-0101
Volume/Issue:
Volume 97: Issue 1
Page(s):
213–221
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Few data are available on the burden of malaria hospitalization in the United States. Study of malaria using hospital-based data can better define the impact of malaria and help inform prevention efforts. U.S. malaria cases identified from hospitalization discharge records in the 2000–2014 Nationwide Inpatient Sample were examined. Frequencies and population rates were reported by demographics, infecting species, clinical, financial, institutional, geographic, and seasonal characteristics, and disparities were identified. Time trends in malaria cases were assessed using negative binomial regression. From 2000 to 2014, there were an estimated 22,029 malaria-related hospitalizations (4.88 per 1 million population) in the United States, including 182 in-hospital deaths and 4,823 severe malaria cases. The rate of malaria-related hospitalizations did not change significantly over the study period. The largest number of malaria-related hospitalizations occurred in August. Malaria-related hospitalizations occurred disproportionately among patients who were male, black, or 25–44 years of age. Plasmodium falciparum accounted for the majority of malaria-related hospitalizations. On average, malaria patients were hospitalized for 4.36 days with charges of $25,789. Patients with a malaria diagnosis were more often hospitalized in the Middle Atlantic and South Atlantic census divisions, urban teaching, private not-for-profit, and large-bed-size hospitals. Malaria imposes a substantial disease burden in the United States. Enhanced primary and secondary prevention measures, including strategies to increase the use of pretravel consultations and prompt diagnosis and treatment are needed.

Author Notes

Address correspondence to Frank J. Sorvillo, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Box 951772, Los Angeles, CA 90095. E-mail: fsorvill@ucla.edu

Authors’ addresses: Diana Khuu, Benjamin N. Bristow, Marjan Javanbakht, Lawrence R. Ash, Shira C. Shafir, and Frank J. Sorvillo, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, E-mails: dkhuu@ucla.edu, benbristowmd@gmail.com, javan@ucla.edu, larryash@ucla.edu, sshafir@ucla.edu, and fsorvill@ucla.edu. Mark L. Eberhard, Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: mle1@cdc.gov.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2017
Received:
10 Feb 2017
|
Accepted:
17 Mar 2017
|
Published Online:
12 Jul 2017
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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