Reported incidence of fever for under-5 children in Zambia: a longitudinal study
Benson M Hamooya1, Gershom Chongwe2, Lungowe Sitali3
1Ministry of Health, P.O Box 30205, Lusaka, Zambia ; Department of Public Health, The University of Zambia, School of Medicine, P.O. Box 50110, Lusaka, Zambia.
Insights
Fever incidence remains high in Zambian children under five, particularly in Chivuna and during the rainy season. Targeted interventions are crucial to reduce childhood fever and its impact on health.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childhood fever is a primary indicator of Plasmodium falciparum infection and a key metric for malaria control program effectiveness.
- This study focuses on the incidence of fever in children under five years old in the rural Magoye and Chivuna areas of Mazabuka district, Zambia.
Purpose of the Study:
- To determine the incidence of fever among children under five years of age in specific rural communities in Zambia.
- To identify predictors associated with multiple episodes of fever in this vulnerable population.
Main Methods:
- A longitudinal study was conducted over 16 months (July 2006-November 2007) involving 1221 children aged 12-59 months.
- Data were collected via structured questionnaires administered to caretakers. Cox proportional hazard regression and Kaplan-Meier survival analysis were employed to analyze fever episodes and survival rates.
Main Results:
- The overall incidence rate of fever was 162.4 per 1000 children per month.
- Fever incidence was significantly higher in Chivuna compared to Magoye (HR 1.35) and during the rainy season (HR 0.17). Older children (37-48 months) had a slightly lower risk of multiple fever episodes (HR 0.81).
- Age and sex were not statistically significant predictors of fever proportion, but location and season were significant predictors of multiple fever episodes.
Conclusions:
- The incidence of fever in the studied rural Zambian communities is high, indicating a substantial burden of febrile illnesses like malaria.
- Febrile illnesses continue to significantly impact the health of children under five in the study population.
- There is a continued need for effective interventions to reduce fever incidence in young children, especially in rural settings.
Background:
Childhood fever is the most common clinical sign of Plasmodium falciparum infection. It is used as a measure of burden of the disease and the effectiveness of control programs for malaria. This study aimed to determine the incidence of fever in under-5 children of Magoye and Chivuna rural areas of Mazabuka district, Zambia.
Methods:
Incidence of fever was evaluated longitudinally over a period of 16 months (July 2006 and November 2007) among children aged 12-59 months in Magoye and Chivuna rural communities. The data was collected for a study on community directed treatment of soil-transmitted helminth infections in under-five children. Data from caretakers of 1221 children were collected using a structured interviewer-administered questionnaire. Cox proportion hazard regression was used to determine predictors of multiple episodes of fever and Kaplan-Meier survival curves was used to compare survival between two groups.
Results:
A total of 1221 under-5 children [median age 32 months; IQR 12-58] participated in the study and 696 (57 %) were from Magoye and 525 (43 %) from Chivuna. The incidence rate of fever was 162.4 per month per 1000 children for the 16 months period. The proportion of fever was not statistically related to children' age [p = 0.779] and sex [p = 0.546]. Predictors of multiple episodes of fever were: age (37-48 vs. 12-24 months) [HR 0.81; 95 % CI 0.67, 0.98; p = 0.030]; location (Chivuna vs. Magoye) [HR 1.35; 95 % CI 1.17, 1.56; p < 0.001]; and season (dry vs. rainy) [HR 0.17; 95 % CI 0.12, 0.23; p < 0.001].
Conclusion:
The study has shown that the incidence of fever was high in the study areas. Febrile illnesses like malaria still have a significant effect on the health of under-5 children in the study population. There still exists the need for interventions aimed at reducing the incidence of fever in under five children, more especially in rural areas.
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