PRESUMPTIVE DIAGNOSIS OF MALARIA IN FEBRILE CHILDREN; IS IT JUSTIFIED?

Authors

  • Animasahun Adeola B Associate Professor, Department of Paediatrics and Child Health, Lagos State University College of Medicine, Ikeja Lagos Nigeria
  • Adekunle Motunrayo O Consultant Paediatrician, Department of Paediatrics and Child Health, Lagos State University College of Medicine, Ikeja Lagos Nigeria
  • Afadapa Maria A Senior Medical Officer, Department of Paediatrics and Child Health, Lagos State University College of Medicine, Ikeja Lagos Nigeria
  • Salisu Mohammed A Department of Paediatrics and Child Health, Lagos State University College of Medicine Ikeja Lagos Nigeria

DOI:

https://doi.org/10.29121/granthaalayah.v5.i12.2017.505

Keywords:

Malaria, Fever, Presumptive Treatment, Nigeria

Abstract [English]

Background: Malaria is deadly and a major disease burden in Africa especially among the under-5s. Due to the high death rate from malaria in endemic region, World Health Organization previous recommendation was presumptive treatment of malaria.


Aim: This study aimed to evaluate if presumptive diagnosis of malaria in our region is still justified, and increase the awareness for proper evaluation for other causes of fever in febrile children.


Methods: Apart of a single blinded prospective interventional study carried out between March and May 2016, at the children outpatient unit of Lagos State University Teaching Hospital, Ikeja, Nigeria. Consecutive children aged 6 months to 12 years with temperature of 37.50C and above at presentation without prior antimalaria treatment were recruited. Clinical and laboratory evaluation for malaria were done in these subjects. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Test of statistical significant was set at <0.05.


Results: Eighty-eight (88) children were recruited. The mean age of studied subjects was 43±46.5 months with a median of 25 months. Male to female ratio was 1.1:1. The axillary temperature range of studied subjects ranged between 37.50C to 390C. The mean temperature of subjects was 37.8±0.370C. Out of 88 children recruited for the study, 51 (58%) had microscopic malaria test being positive. Up to 37 (42%) febrile children tested negative for malaria.


Conclusion: Malaria infection in children is still high in our environment, but presumption treatment of malaria is no longer justified. There is a need to scale up provision of diagnostic tools for malaria so that overtreatment can be curtailed.

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References

World Health Organization. World Malaria Report.2015. http//www.who.int (Last Accessed 03 September 2016)

President’s Malaria Initiative Nigeria. Malaria Operational Plan FY 2015.

President’s Malaria Initiative Strategy. https://www.pmi.gov/ (Last Accessed 03 September, 2016)

WHO: Guidelines for the treatment of malaria 2006, Geneva: WHO.

WHO: Guidelines for the treatment of malaria (2e).2010, Geneva: World Health Organization, 2.

Graz B, Willcox M, Szeless T, Rougemont A. “Test and Treat” or presumptive treatment for malaria in high transmission situation? A reflection on the latest WHO guidelines. Malaria Journal 2011, 10:136. DOI: https://doi.org/10.1186/1475-2875-10-136

Ikeh EI, Teclaire NN. Prevalence of malaria parasitemia and associated factors in febrile under-5chidren seen in Primary Health Centres in Jos, North Central Nigeria. Niger Postgrad Med J, 2008 Jun;15(2):65-9

Abdulkadir I, Rufai HA, Ochapa SO, Malam MS, Garba BI, Oloko AY, George II. Malaria rapid diagnostic test in children: The Zamfara, Nigeria experience. Niger Med J 2015[serial online] 2015[cited 2016 Jun 26]; 56:278-82. DOI: https://doi.org/10.4103/0300-1652.169744

WHO. Basic Malaria Microscopy Part1. Learner’s guide; Part II Tutor’s guide. Geneva, World Health Organization, 1991.

Singh S, Madaki AJ, Jiya NM, Singh R, Tracher TD. Predictors of malaria in febrile children in Sokoto, Nigeria. Niger Med J 2014 Nov-Dec;55(6):480-485. DOI: https://doi.org/10.4103/0300-1652.144701

Oladosu OO, Oyibo WA. Overdiagnosis and overtreatment of malaria in children that presented with fever in Lagos, Nigeria. ISRN Infectious Diseases.2013;2013:1-6 DOI: https://doi.org/10.5402/2013/914675

Mazigo HD, Meza W, Ambrose EE, Kidenya BR, Kweka EJ. Confirmed malaria cases among children under five with fever and history of fever in rural western Tanzania. BMC Research. 2011; 359:1-6. DOI: https://doi.org/10.1186/1756-0500-4-359

Okoro CI, Chukwuocha UM, Nwakwuo GC, Ukaga CN. Presumptive Diagnosis and Treatment of Malaria in Febrile Children in Parts of South Eastern Nigeria. J Infect Dis Ther. 2015; 3:5

Odinaka KK, Edelu BO, Nwolisa EC, Amamilo IB, Okolo SN. Accuracy of subjective assessment of fever by Nigerian mothers in under-5 children. Niger Med J. 2014; 55(4):338-341. DOI: https://doi.org/10.4103/0300-1652.137226

Umaru ML, Uyaiabasi GN. Prevalence of Malaria in Patients Attending the General Hospital Makarfi, Makarfi Kaduna-State, North Western Nigeria. American Journal of Infectious Diseases and Microbiology .2015;13(1):1-5.

Mbanugoji, Ejim DO. Plasmodium Infections in Children Aged 0-5Yrs in Akwa Metropolis, Anambra State, Nigeria. Nigerian J of Parasitology. 2000; 21:55-59

Nwaorgu OC, Orajaka BN. Prevalence of Malaria among Children 1-10 Years Old in Communities in Akwa North Local Government Area, Anambra State South East Nigeria. International Multidisciplinary Journal Ethiopia;5(5) serial No 22, Oct, 2011:264-281. DOI: https://doi.org/10.4314/afrrev.v5i5.21

Nmadu PM, Peter E, Alexander AZ, Koggie AZ, Maikenti JI. The Prevalence of Malaria in Children between the Ages 2-15 visiting Gwarinpa General Hospital Life-Camp, Abuja, Nigeria. Journal of Health Science. 2015;5(3):47-51

The public health burden of plasmodium falciparum malaria in Africa: Deriving the numbers by Robert W Snow, Merlies H Craig, Charles R.J.C. Newton, and Richard W. Steketer. Working paper No. 11, Disease control priorities project. Bethesda, Maryland: Fogarty International Center, National Institutes of Health, August 2003.

Temiye Edamisan. Paediatrician says respiratory infection, malaria major illnesses in children during rainy season. In News Agency of Nigeria Jun 25, 2015.

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Published

2017-12-31

How to Cite

Adeola B, A., Motunrayo O, A., Maria A, A., & Mohammed A, S. (2017). PRESUMPTIVE DIAGNOSIS OF MALARIA IN FEBRILE CHILDREN; IS IT JUSTIFIED?. International Journal of Research -GRANTHAALAYAH, 5(12), 291–297. https://doi.org/10.29121/granthaalayah.v5.i12.2017.505