Malaria Parasitemia in Children Aged less than 5 Years Presenting with Fever in Kaduna, Northwestern Nigeria.

Abstract

Background: Malaria is a significant cause of morbidity and mortality in sub Saharan Africa. Fever is the commonest manifestation and Children aged less than 5 years are most vulnerable. An appraisal of this disease among these children is important to reducing the impact of the disease.

Objective: To determine the prevalence and identify factors affecting malaria parasitemia in febrile children aged less than 5 years.

Methods: Blood samples taken from all febrile children aged less than 5 years who presented to the department of Pediatrics, 44 Nigeria Army Reference Hospital Kaduna(NARHK) between July 2011 and September 2011, were examined for presence of malaria parasites.

Results: Out of the 730 febrile children assessed, 411 (56.3%) had malaria parasitemia with densities of +, 2+ and 3+ in 301(73.2%), 90(22%) and 20(4.8%) children respectively. Majority were males (476, 65.2%), Aged = 2 years (409, 56% ) and in the upper (I III) social classes (497, 68.1%). Most (523, 71.6%) presented within = 48 hours of illness. Anti-malaria drug use was observed in 426 (58.4%) children and Artemisinin-based Anti-malaria Combination Therapy (ACT) drugs were the commonest drugs used (247, 58%). Drugs were prescribed by caregiver (183, 43%), patent medicine seller (102, 23.9%), in a health facility (94, 22.1%) and by significant others (47, 11%) respectively. Only 95(13%) used Insecticide Treated Nets (ITNs) and 34(4.6%) used traditional herbal mixtures. Malaria parasitemia was significantly (p?0.05) associated with non use of anti-malaria drug, low social class, non usage of ITNs and age =2 years .Of those with malaria parasitemia 396(96.4%) were treated for uncomplicated malaria and recovered fully. Fifteen (3.7%) were admitted and treated for severe malaria, of which 13(86.7%) of them recovered fully and 2(13.3%) died.

Conclusion: Malaria is still a major cause of morbidity among febrile children aged less than 5 years of age with the severe form occurring less frequently but with grave consequences.

Keywords: Malaria parasite, Fever, Children