[Malaria morbidity at the Center for Maternal and Child Prevention of the Central Hospital, Yaounde, Cameroon. Observations of a sample of 903 infants].
From April 1988 to March 1989, 903 randomly chosen children were examined in the Maternal and Child Health Department of the Central Hospital of Yaounde (Cameroon) to determine the importance of malaria in general morbidity, the relation between clinical symptoms and parasite densities and to have some idea of the population's self-medication behaviour. We adopted the criteria formerly worked out in West Africa, i.e. a fever (t degree higher than 37.9 degrees C) without any obvious febrile disease and a parasitaemia higher than 10,000 red blood cells parasitized by Plasmodium falciparum/mm3. In the sample under investigation, the average plasmodic index was 32.5%, mainly P. falciparum (98% of all infections), while 120 children had a parasitaemia higher than the critical level of 10,000 par./mm3 (i.e. 13.3% of the whole sample and 40.1% of Plasmodium carriers. 559 of the 903 children were actually febrile and among them 94 had a so-called malaria crisis (i.e. 16.8% of fevers and 10.4% of all consultations). It was confirmed that not one single clinical symptom is pathognomic for malaria crisis but fever, splenomegaly and anaemia seemed to occur more frequently among sick children. It also appeared that the proportion of children with fever increased as their parasitaemia exceeded the critical threshold of 10,000 par./mm3, while splenomegaly tends to drop with very high parasitaemia. Faced with fever as a clinical symptom, self-medication is a common behaviour (65% of people interviewed admitted such practice); it is mainly based upon chloroquine tablet ingestion but at a subcurative dosage. Such self-medication could induce an underestimation of malaria morbidity from clinical statistics and, on the other hand, a growing drug pressure, which could play a role in the current spread of P. falciparum chloroquine resistant strains in Central Africa and elsewhere in sub-saharan regions.
Loué
P
P
Andela
A
A
Carnevale
P
P
D000818:Animals; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011446:Prospective Studies; D012494:Sampling Studies; D012651:Self Medication
D002738:Chloroquine
Etude de la morbidité palustre au Centre de Prévention Maternelle et Infantile de l'Hôpital Central, Yaoundé, Cameroun. Observations d'un échantillon de 903 enfants.