Malaria in children in Ilorin, Nigeria.
OBJECTIVE
To determine the prevalence of paediatric malaria admissions in an area of stable malaria transmission and to ascertain the relative contributions of different forms of severe malaria to morbidity and mortality.


METHODS
A descriptive restrospective study.


METHODS
Olanrewaju hospital, a general practice health facility in a malaria holoendemic city in Nigeria.


METHODS
Case files of paediatric (age < 15years) admissions between 1/1/98 and 31/12/98with a diagnosis of acute malaria were retrieved and relevant information including demographic data, clinical signs, laboratory records, treatments received and diagnosis on discharge were extracted. Grouped age-associated prevalence rates were calculated; characteristics of different groups were compared using standard statistical methods.


RESULTS
Children with Falciparum malaria accounted for 95 (18%) of the 526 medical admissions. The proportion of children admitted with severe malaria was significantly higher among the under-fives compared to those over five years (p < 0.001; RR = 5.36, 95% CI of 2.58 to 11.2). Thirty two (33.7%) children had severe malaria. Fifteen (15.8%) had convulsions without coma, 13 (13.68%) had malaria-associated anaemia and four (4.2%) were diagnosed as having had cerebral malaria. Seizures were significantly more frequent in the under-fives (p=0.001, RR=6.0; 95% CI of 1.8 to 19.6). There was a significant negative correlation between age and severe anaemia/blood transfusions (p = 0.002). Cerebral malaria carried the greatest risk of fatality (CFR=25%; RR=7, 95% CI of 1.5 to 91).


CONCLUSIONS
High prevalence of paediatric malaria admissions in this study underscores the morbidity burden in Nigerian children, especially in under-fives in whom the severe forms are more common. A high incidence of anaemia requiring blood transfusions further increases the risk of paediatric HIV infection in Nigeria where organised control programmes are rudimentary.
Olanrewaju
W I
WI
Malaria Resource Centre/Olanrewaju Hospital, Nigeria.
Johnson
A W
AW
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D010343:Patient Admission; D015995:Prevalence; D012189:Retrospective Studies; D015996:Survival Rate