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Non-malaria fevers in a high malaria endemic area of Ghana
Kwaku Poku Asante1, Seth Owusu-Agyei2,3, Matthew Cairns3
1Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana. kwakupoku.asante@kintampo-hrc.org.
Insights
Non-malaria fevers (NMFs) are common in infants in Ghana. Low birth weight and poor socioeconomic status increase NMF risk, while placental malaria does not significantly impact it.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Non-malaria fevers (NMFs) are increasingly recognized as a significant health concern in children in sub-Saharan Africa.
- This study investigates risk factors for NMFs in Ghanaian children, focusing on exposure-related factors and placental malaria.
Purpose of the Study:
- To determine the incidence of NMFs in infants in Kintampo, Ghana.
- To examine the association between NMFs and factors such as low birth weight, socioeconomic status, proximity to health facilities, and placental malaria.
Main Methods:
- A cohort of 1855 newborns was enrolled and followed for up to 24 months.
- Passive case detection was used to identify episodes of illness.
- Statistical analysis, including adjusted hazard ratios (aHR), was performed to assess risk factors.
Main Results:
- The incidence of NMFs in the first year of life was 1.60 per child-year.
- NMF incidence was significantly higher in infants with low birth weight (aHR 1.22), from poor socioeconomic households (aHR 1.22), and living further from health facilities (aHR 1.20).
- No significant association was found between NMF incidence and placental malaria (aHR 0.97).
Conclusions:
- NMFs are highly prevalent in infancy in the study area.
- Low birth weight and poor socioeconomic status are identified as key risk factors for NMFs.
- Placental malaria does not appear to be a significant risk factor for NMFs in this population.
Background:
The importance of fevers not due to malaria [non-malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission.
Methods:
Between 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12 months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12 months of age, with an exploratory analysis of a sub-group of children followed for up to 24 months.
Results:
The incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95 % CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95 % CI 1.04-1.42) p = 0.012], infants from households of poor socio-economic status [aHR 1.22 (95 % CI 1.02-1.46) p = 0.027] and infants living furthest from a health facility [aHR 1.20 (95 % CI 1.01-1.43) p = 0.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; p = 0.584)].
Conclusion:
The incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria.
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