Published online August 31, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. e745-e748 (doi:10.1542/10.1542/peds.2007-0041)
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EXPERIENCE & REASON

Clinical Malaria and Sickle Cell Disease Among Multiple Family Members in Chicago, Illinois

Daniel Glikman, MDa, Phuc Nguyen-Dinh, MD, MPHb, Jacquelin M. Roberts, MSb, Christopher P. Montgomery, MDc, Robert S. Daum, MDa and John F. Marcinak, MDa

a Sections of Infectious Diseases
c Critical Care, Department of Pediatrics, University of Chicago, Chicago, Illinois
b Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

ABSTRACT

Malaria is a disease of global importance and accounts for up to 500 million cases per year. Nearly all malaria cases in the United States occur among persons who have traveled to areas with ongoing malaria transmission. Among the cases of malaria reported in the United States in 2000–2005, 695 were in US residents under the age of 18 years. The association of malaria with the sickle cell hemoglobin is well described in Africa but is a rare occurrence in the United States. Here we report 5 cases of Plasmodium falciparum malaria in siblings of a family who had traveled to Africa without taking chemoprophylaxis. Two of the children had sickle cell anemia, and 1 of them developed severe life-threatening malaria and hemolysis. The 3 other siblings had sickle cell trait, 2 of whom had complicated malaria. Patients who have sickle cell disease and are infected with malaria are prone to hyperhemolytic crisis; therefore, this complication should be anticipated. The patients we describe emphasize the significance of prompt recognition of malaria and comorbidities and institution of appropriate treatment. The importance of antimalarial prophylaxis should be communicated to parents of children who are traveling to endemic areas as part of routine child care.

Key Words: malaria • children • sickle cell disease • chemoprophylaxis • United States

Abbreviations: CDC; Centers for Disease Control and Prevention • PCR; polymerase chain reaction

Accepted Mar 27, 2007.


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Malarial chemoprophylaxis
BMJ, October 1, 2008; 337(oct01_3): a1875 - a1875.
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