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Malaria in children in Ilorin, Nigeria
1Malaria Resource Centre/Olanrewaju Hospital, Nigeria.
Insights
Paediatric malaria is a significant health burden in Nigeria, particularly for children under five. Severe malaria, including cerebral malaria and anaemia, is more prevalent in this age group, highlighting the need for improved control programs.
Area of Science:
- Medical Research
- Tropical Medicine
- Epidemiology
Background:
- Malaria remains a major public health challenge in malaria-holoendemic regions.
- Paediatric admissions significantly contribute to the disease burden in endemic areas.
- Understanding the specific forms and prevalence of severe malaria in children is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of paediatric malaria admissions.
- To identify the different forms of severe malaria contributing to morbidity and mortality.
- To analyze age-specific risks and outcomes of severe malaria in children.
Main Methods:
- A retrospective descriptive study was conducted.
- Data was collected from paediatric case files (<15 years) admitted with acute malaria.
- Statistical methods were used to compare age-associated prevalence and characteristics of severe malaria cases.
Main Results:
- Plasmodium falciparum malaria accounted for 18% of paediatric medical admissions.
- Severe malaria was significantly more common in children under five years (RR=5.36).
- Cerebral malaria had the highest case fatality rate (25%), with seizures more frequent in under-fives.
Conclusions:
- Paediatric malaria admissions represent a substantial morbidity burden in Nigerian children, especially under-fives.
- High rates of severe malaria and anaemia requiring transfusions pose significant risks.
- Rudimentary malaria control programs necessitate urgent improvements to reduce paediatric mortality and morbidity.
Objectives:
To determine the prevalence of paediatric malaria admissions in an area of stable malaria transmission and to ascertain the relative contributions of different forms of severe malaria to morbidity and mortality.
Design:
A descriptive restrospective study.
Setting:
Olanrewaju hospital, a general practice health facility in a malaria holoendemic city in Nigeria.
Subjects And Methods:
Case files of paediatric (age < 15years) admissions between 1/1/98 and 31/12/98with a diagnosis of acute malaria were retrieved and relevant information including demographic data, clinical signs, laboratory records, treatments received and diagnosis on discharge were extracted. Grouped age-associated prevalence rates were calculated; characteristics of different groups were compared using standard statistical methods.
Results:
Children with Falciparum malaria accounted for 95 (18%) of the 526 medical admissions. The proportion of children admitted with severe malaria was significantly higher among the under-fives compared to those over five years (p < 0.001; RR = 5.36, 95% CI of 2.58 to 11.2). Thirty two (33.7%) children had severe malaria. Fifteen (15.8%) had convulsions without coma, 13 (13.68%) had malaria-associated anaemia and four (4.2%) were diagnosed as having had cerebral malaria. Seizures were significantly more frequent in the under-fives (p=0.001, RR=6.0; 95% CI of 1.8 to 19.6). There was a significant negative correlation between age and severe anaemia/blood transfusions (p = 0.002). Cerebral malaria carried the greatest risk of fatality (CFR=25%; RR=7, 95% CI of 1.5 to 91).
Conclusion:
High prevalence of paediatric malaria admissions in this study underscores the morbidity burden in Nigerian children, especially in under-fives in whom the severe forms are more common. A high incidence of anaemia requiring blood transfusions further increases the risk of paediatric HIV infection in Nigeria where organised control programmes are rudimentary.