MALARIA IN CHILDREN IN ILORIN, NIGERIA
Abstract
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 rnethods: Case files of paediatric (age <15years) admissions between 1/1/98 and
31/12/98 with 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=S.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 anaemialblood 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 infectionin Nigeria where organised control programmes
are rudimentary.
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 rnethods: Case files of paediatric (age <15years) admissions between 1/1/98 and
31/12/98 with 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=S.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 anaemialblood 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 infectionin Nigeria where organised control programmes
are rudimentary.
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