Table 1.
Severe Morbidity and Mortality With a Diagnosis of Plasmodium falciparum Relative to That of Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale Among Travelers Presenting in the United States, 1985–2011
| Syndrome* |
P. falciparum |
P. vivax |
P. falciparum vs P. vivax |
||||||
|---|---|---|---|---|---|---|---|---|---|
| Syndrome (+) | Syndrome (−) | % | Syndrome (+) | Syndrome (−) | % | OR | 95% CI | P value | |
| Fatal among all cases† | 122 | 13 849 | 0.9% | 10 | 11 446 | 0.09% | 10.08 | 5.29, 19.22 | <.0001 |
| Severe | 1416 | 13 856 | 9.3% | 163 | 11 989 | 1.3% | 7.46 | 6.33, 8.79 | <.0001 |
| Fatal† | 122 | 1091 | 8.6% | 10 | 143 | 6.1% | 1.60 | .82, 3.12 | .1649 |
| Cerebral malaria | 514 | 902 | 36.3% | 37 | 126 | 22.7% | 1.94 | 1.32, 2.84 | .0006 |
| ARDS | 176 | 1240 | 12.4% | 35 | 128 | 21.5% | .52 | .35, .78 | .0013 |
| Renal | 503 | 913 | 35.5% | 48 | 115 | 29.4% | 1.32 | .93, 1.88 | .1235 |
| Severe anemia‡ | 140 | 434 | 24.4% | 16 | 45 | 26.2% | .91 | .50, 1.66 | .7512 |
| Syndrome* |
P. malariae |
P. falciparum vs P. malariae |
P. ovale |
P. falciparum vs P. ovale |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Syndrome (+) | Syndrome (−) | % | OR | 95% CI | P Value | Syndrome (+) | Syndrome (−) | % | OR | 95% CI | P Value | |
| Fatal among all cases† | 2 | 1195 | 0.2% | 5.26 | 1.30, 21.31 | .0092 | 2 | 807 | 0.3% | 3.55 | .88, 14.40 | .0577 |
| Severe | 22 | 1232 | 1.8% | 5.72 | 3.74, 8.75 | <.0001 | 18 | 885 | 2.0% | 5.02 | 3.14, 8.04 | <.0001 |
| Fatal† | 2 | 20 | 9.1% | 1.12 | .26, 4.84 | .8812 | 2 | 15 | 11.8% | .84 | .19, 3.71 | .8165 |
| Cerebral malaria | 4 | 18 | 18.2% | 2.56 | .86, 7.62 | .0791 | 2 | 16 | 11.1% | 4.56 | 1.04, 19.91 | .0270 |
| ARDS | 1 | 21 | 4.5% | 1.25 | .40, 22.30 | .2642 | 2 | 16 | 11.1% | 1.14 | .26, 4.98 | .8662 |
| Renal | 6 | 16 | 27.3% | 1.47 | .57, 3.78 | .4221 | 7 | 11 | 38.9% | .87 | .33, 2.25 | .7670 |
| Severe anemia‡ | 6 | 5 | 54.5% | .27 | .08, .89 | .0222 | 3 | 7 | 30.0% | .75 | .19, 2.95 | .6828 |
Abbreviations: ARDS, acute respiratory distress syndrome; CI, confidence interval; OR, odds ratio.
*The total number of cases do not sum to the total number of severe cases due to missing outcome data.
†Cases could have more than one syndrome or clinical complication in the course of their illness, thus the number of cases that are syndrome (+) do not sum to the total classified as severe. Analyses of individual syndromes are among those who are classified as having severe disease.
‡2008–2011 reporting only.