The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66862

Kathryn Legaspi, RN, MPH¹, Michael Phillips, MD¹, Carmen Roman¹, Gloria Okoh, MPH¹, Marcelle Layton, MD², and Don Weiss, MD, MPH³. (1) Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, 125 Worth St. CN-22A, New York, NY 10013, 212-788-9638, klegs3@aol.com, (2) Assistant Commissioner, Bureau of Communicable Disease, New York City Department of Health, 125 Worth St, New York, NY 10013, (3) Bureau of Communicable Disease, New York City Department of Health, 125 Worth St, CN- 22A, New York, NY 10013

Background: In the past 2 decades, the annual incidence of malaria in New York City (NYC) has increased from 0.4 to 3.0 cases per 100,000. During 1999-2001, 615 cases of malaria were reported; 405 (66%) of these cases occurred among West African immigrants (WAI) upon returning to NYC after visiting Africa. Due to concern about use of malaria chemoprophylaxis among NYC malaria cases, we interviewed malaria cases to determine knowledge, attitudes and practice regarding prevention of malaria.

Methods: All 2002 confirmed malaria case-patients were interviewed using a standardized questionnaire to obtain information on clinical illness, awareness of malaria prophylaxis, pre-travel medical care access, and barriers to healthcare. The cost of malaria treatment was estimated by obtaining average costs of hospital and outpatient treatments.

Results: During 2002, 153 (75%) of the 205 malaria cases reported in NYC occurred in WAI after visiting Africa; 73 (48%) of 153 WAI malaria case-patients resided in the South Bronx. Seventy-seven (50%) of 153 WAI malaria case-patients were interviewed. Of the 77 interviewed, 71% were not worried about travel related illnesses, 60% did not have a primary care provider, and 40% did not have health insurance. The 2002 estimated cost of malaria treatment in WAI was $2,314,000.

Conclusion: The majority of NYC malaria cases occur in WAI, where awareness of the need for chemoprophylaxis is low. Significant barriers include perceived susceptibility, lack of primary care and insurance. Our next steps are producing educational materials with community focus group input and identifying local organizations to be partners in this project.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to:
• 1.Identify a target population using surveillance data in order to begin a prevention program.
• 2.Develop a viable health promotion program for a targeted population with complex needs.

Keywords: Prevention, Immigrants

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.