WIP 79 - Demographic Features and Insurance Status of Children with Malaria admitted to a Pediatric Hospital in the United States

Publication Number: WIP 79.7492

Shreya Doshi, Children's National Health System, Washington DC, DC, United States; Emily Ansusinha, Children's National Health System, Washington, DC, United States; Alexandra Yonts, Children's National Health System, Silver Spring, MD, United States; Barbara Jantausch, Children's National Health System, Washington, DC, United States

Background: Malaria infects~ 250 million globally, with U.S. pediatric cases often reflecting unique factors (insurance, immigration status). This study conducted at a U.S. hospital serving a large immigrant population, assesses demographics, insurance status, and healthcare disparities in children with malaria. We examine travel patterns, travel reasons and follow-up care adherence, comparing insured and uninsured patients on time to presentation and length of stay to identify disparities that may inform future policies for at-risk children.

Objective: 1. Assess demographic and socioeconomic profiles (age, sex, race, immigration, insurance status) in pediatric malaria cases
2. Analyze travel patterns and reasons (e.g., visiting family, school)
3. Evaluate follow-up care adherence among insured and uninsured patients.
4. Compare clinical outcomes (time to presentation, length of stay) based on insurance status

Design/Methods: IRB-approved, retrospective study (Jan 2010–Jan 2024) with 169 cases of pediatric malaria, including 66 severe cases due to Plasmodium falciparum. Both severe and non-severe cases analyzed. Inclusion: patients < 21 years diagnosed with malaria. Exclusion: Incomplete records

Definitions
Travel Patterns: U.S.-based returning travelers, recent immigrants ( < 6 months), travelers to U.S. from another country
Severe Malaria: ≥5% parasitemia or end-organ damage
Insurance Status: Insured (public, private, military) vs. uninsured
Follow-up Care: Adherence to clinic visit within 30 days post-discharge

Data Collection
Data collected from ICD-9/10 codes and enetered in REDCap

Data Analysis
Descriptive statistics and chi-square/t-tests will assess insurance-related disparities in outcomes; regression models will analyze follow-up adherence

Preliminary Findings
Among 66 severe cases, 24% were recent immigrants and 24% uninsured. Non-severe case analysis is ongoing. Final analysis will conclude in April 2024. Results from this study are expected to guide policy reforms that address healthcare disparities and enhance support for immigrant and uninsured children with malaria.