Predisposition of Nigerian children with severe malaria to urinary tract infection

Abstract

The predisposition of children with severe malaria to urinary tract infection was investigated in a group of 112 clinically diagnosed and para sitologically confirmed severe malaria patients (test) and in another subset of 114 apparently physically healthy non-malaria infected subjects (control). Standard bacteriological and parasitological procedures were used in the diagnosis of urinary tract infection and confirmation of malaria infection respectively. Plasmodium falciparum was the only aetiologic agent of malaria encounted in the study. There was a statistically significant difference (P = 0.008) in the prevalence of urinary tract infection in severe malaria infected patients (30.4%) and control (2.6%) (P<0.001). Patients with higher levels of parasitaemia had more chances of developing urinary tract infection. The geometric mean parasite density did not vary significantly with the age of severe malaria patients (F = 0.81, P = 0.49). Although female patients had more cases of severe malaria and urinary tract infection than males, the differences in the rate of occurrence of both parameters were not statistically significant (P = 0.63 for malaria and P = 0.95 for urinary tract infection). Escherichia coli was the predominant agent of urinary tract infection isolated in the study. It is suggested that the alteration of the physiology of the kidney and the lowered immunity prompted by severe malaria may be the enabling factors for the initiation of urinary tract infection. Screening for urinary tract infection among severe malaria patients is advocated in malaria endemic areas.

Keywords: Severe malaria, children, urinary tract infection

Nigerian Journal of Health and Biomedical Sciences Vol. 5 (2) 2006: 52-56