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Heavy Malaria Parasitaemia in Young Nigerian Infants: Prevalence, Determinants and Implication for the Health System
O F Folarin1, B P Kuti1,2, A O Oyelami1,2
1Department of Paediatrics, Wesley Guild Hospital, Ilesa, Osun State, Nigeria.
Insights
About 24% of ill infants under six months with malaria had heavy parasitaemia. Pallor was a key predictor, indicating a need for increased suspicion in malaria-endemic areas.
Area of Science:
- Pediatrics
- Infectious Diseases
- Malariology
Background:
- Young infants (≤6 months) typically have mild malaria infections.
- Increasing reports of severe malaria complications in this age group.
- Need to understand heavy malaria parasitaemia in infants aged 1-6 months.
Purpose of the Study:
- Determine the prevalence of heavy malaria parasitaemia in infants aged 1-6 months.
- Identify clinical determinants of heavy malaria parasitaemia.
- Assess public health implications of heavy malaria parasitaemia.
Main Methods:
- Recruited ill infants (1-6 months) over 11 months.
- Conducted clinical examinations and blood films for malaria parasites.
- Defined heavy parasitaemia as >5000 parasites/µl; determined clinical predictors.
Main Results:
- Heavy parasitaemia found in 16 (23.9%) of 67 malaria-infected infants.
- Fever, excessive crying, and pallor associated with heavy parasitaemia.
- Pallor independently predicted heavy parasitaemia (OR=20.653, p=0.010).
Conclusions:
- Nearly one in four ill young infants with malaria exhibited heavy parasitaemia.
- Pallor is a significant clinical predictor of heavy malaria parasitaemia.
- Suspicion of heavy malaria parasitaemia should increase with pallor in endemic settings.
Background:
Infants who are aged six months and below are often protected from malaria and usually present with light parasitaemia when infected. However, complications following heavy malaria parasitaemia in this age group are being increasingly reported. This study set out to determine the prevalence, determinants and the public health implications of heavy malaria parasitaemia in young infants (aged one to six months) at the Wesley Guild Hospital, Ilesa (a unit of the Obafemi Awolowo University Teaching Hospitals Complex).
Methods:
Ill infants aged one to six months in out-patient and in-patient care were recruited over an 11-month period. Clinical examinations and blood film for malaria parasite were done for all the study participants. Heavy parasitaemia was defined as > 5000 parasites/µl. Clinical predictors of heavy parasitaemia were determined.
Results:
Heavy parasitaemia was observed in 16(23.9%) of the sixty-seven participants with malaria infection. Presence of fever at presentation (p=0.007), excessive crying (p=0.003) and pallor (p=0.001) were associated with heavy malaria parasitaemia. However, pallor (OR = 20.653; 95%CI 2.091-203.958; p=0.010) was the only independent predictor of heavy parasitaemia among the young infants.
Conclusion:
About one-in-four ill young infants with malaria had heavy parasitaemia, which was predicted by pallor. Hence, the presence of pallor and factors related to low parental socio-economic status should increase the suspicion of heavy malaria parasitaemia in ill young infants in malaria endemic settings.
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