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Malarial parasitaemia in febrile children with sickle cell anaemia

H O Okuonghae1, M U Nwankwo, E Offor

  • 1Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.

Journal of Tropical Pediatrics
|April 1, 1992
PubMed

Insights

In children with sickle cell anaemia (SCA) on antimalarial prophylaxis, bacterial infections are more common causes of fever than malaria. Prompt screening for bacterial infections is crucial for effective treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Sickle cell anaemia (SCA) increases susceptibility to infections.
  • Antimalarial prophylaxis is common in children with SCA.
  • Fever in SCA patients can be challenging to diagnose.

Purpose of the Study:

  • To investigate the causes of fever in children with SCA receiving antimalarial prophylaxis.
  • To compare the prevalence of malarial parasitaemia and bacteraemia in febrile children with and without SCA.

Main Methods:

  • Prospective study of 166 febrile episodes in 162 children with SCA (6 months-16 years) and controls.
  • Rectal temperature ≥38.3°C was the criterion for fever.
  • Blood samples were tested for malarial parasitaemia and bacteraemia.

Main Results:

  • Malarial parasitaemia was lower in SCA patients (9%) than controls (29%) (P<0.0001).
  • Bacteraemia occurred in 33% of SCA patients and 26% of controls (P>0.10).
  • Bacteraemia was the most frequent cause of fever in SCA patients on prophylaxis.

Conclusions:

  • Bacterial infections are a more common cause of significant pyrexia in SCA children on antimalarial prophylaxis than malaria.
  • Children with SCA presenting with fever while on prophylaxis require thorough bacterial screening.
  • Early and appropriate antimicrobial therapy is recommended for suspected bacterial infections in these patients.

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