PT - JOURNAL ARTICLE AU - Williams, J P AU - Chitre, M AU - Sharland, M TI - Increasing <em>Plasmodium falciparum</em> malaria in southwest London: a 25 year observational study AID - 10.1136/adc.86.6.428 DP - 2002 Jun 01 TA - Archives of Disease in Childhood PG - 428--430 VI - 86 IP - 6 4099 - http://adc.bmj.com/content/86/6/428.short 4100 - http://adc.bmj.com/content/86/6/428.full SO - Arch Dis Child2002 Jun 01; 86 AB - Aims: To identify changes in the presenting number and species of imported malaria in children in southwest London.Methods: A prospective single observer study over 25 years (1975–99) of all cases of paediatric malaria seen at St George's Hospital.Results: A confirmed diagnosis was made in 249 children (56% boys; 44% girls; median age 8.0 years). Of these, 53% were UK residents and 44% were children travelling to the UK. A significant increase was noted in the number of cases over the 25 years (1975–79: mean 4.8 cases/year; 1990–99: mean 13.7 cases/year). Over the 25 years Plasmodium falciparum was seen in 77%, P vivax in 14%, P ovale in 6%, and P malariae in 3% of cases. P falciparum had increased in frequency (1975–79: P falciparum 50%, P vivax 50%; 1990–99: P falciparum 82%, P vivax 6%), associated with an increase in the proportion of children acquiring their infection in sub-Saharan Africa. Median time between arrival in the UK to the onset of fever was: P falciparum, 5 days; P ovale, 25 days; P malariae, 37 days; and P vivax, 62 days. Median time interval between the onset of fever to commencement of treatment was 4 days. This had not improved over the 25 year period. Only 41% of UK resident children presenting to hospital had taken prophylaxis and the overall number of symptomatic children taking no prophylaxis was increasing.Conclusion: Imported childhood P falciparum malaria is increasing in southwest London associated with increasing travel from sub-Saharan Africa. Over the 25 year period there has been no improvement in chemoprophylaxis rates or time to diagnosis.