Malaria Morbidity and Mortality in Owerri Hospitals

Abstract

Generally in a typical Nigerian setting, hospital visits for the treatment of malaria are usually cases of severe malaria where home remedies including over- the-counter drugs have failed. A descriptive epidemiological survey of malaria using hospital records was carried out in the three geopolitical zones (Local Government Areas) of Owerri, Imo State, Nigeria to give a picture of severe malaria in the city. Yearly regular survey for a period of six years (2000-2006) revealed an overall prevalence of 23.8% calculated over the years. In characterising the sample population, children aged between 0 and 5 years were observed to have recorded the highest incidence of malaria with 70.1% reported hospital cases, followed by pregnant mothers (35.0%) in descending order. Yearly prevalences of 17.4%, 14.9%, 23.9%, 23.4%, 33.0%, 22.2% and 32.9% respectively were recorded for the years 2000 to 2006. Chi- square analysis did not show any significant difference between the various prevalence rates (p=0.05). Gender-related rates of reported hospital cases showed a total prevalence of 22.5% and 25.4% for males and females respectively. Amongst the different Local Government Areas, Owerri West recorded the highest cases of hospital that treated malaria with (29.7%) followed by Owerri North (22.2%), with the least (21.6%) observed for Owerri Municipal. Malaria related cases in out-patient clinics and admission yielded prevalence of 3.1% and 8.9% respectively, for the total attendance. Overall malaria related mortality was observed as 1.2%. Most of the death (74 deaths) cases were observed within the age group of 0-14 years. On the clinical picture of malaria as recorded in the hospitals, Cerebral malaria, malaria in pregnancy, malaria in children, malaria relapse, and malaria with anaemia yielded total occurrence rates of 1.7%, 5.7%, 6.4%, 1.6%, and 4.4% respectively over the years. More cases of pregnant women with malaria was reported in the year 2002(45.0%) and there was a reduction trend from 2004, with the least reported rates (22.9%) in 2006. Similarly, more cases of malaria in children were recorded in the year 2002 (62.5%) while a reduction trend (29.1%) was observed in the year 2006. Chi- square analysis showed a significant difference among the various years (P=0.05).

Keywords: malaria, morbidity, mortality, epidemiology, Owerri, hospital records

Nigerian Journal of Parasitology, Vol. 32 [2] September 2011, pp.175-180