RT Journal Article SR Electronic T1 Increasing Plasmodium falciparum malaria in southwest London: a 25 year observational study JF Archives of Disease in Childhood JO Arch Dis Child FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 428 OP 430 DO 10.1136/adc.86.6.428 VO 86 IS 6 A1 Williams, J P A1 Chitre, M A1 Sharland, M YR 2002 UL http://adc.bmj.com/content/86/6/428.abstract 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.