Severe falciparum malaria in young children of the Kassena-Nankana district of northern Ghana.
METHODS
Severe falciparum malaria in children was studied as part of the characterization of the Kassena-Nankana District Ghana for future malaria vaccine trials. Children aged 6-59 months with diagnosis suggestive of acute disease were characterized using the standard WHO definition for severe malaria.


RESULTS
Of the total children screened, 45.2% (868/1921) satisfied the criteria for severe malaria. Estimated incidence of severe malaria was 3.4% (range: 0.4-8.3%) cases per year. The disease incidence was seasonal: 560 cases per year, of which 70.4% occurred during the wet season (June-October). The main manifestations were severe anaemia (36.5%); prolonged or multiple convulsions (21.6%); respiratory distress (24.4%) and cerebral malaria (5.4%). Others were hyperpyrexia (11.1%); hyperparasitaemia (18.5%); hyperlactaemia (33.4%); and hypoglycaemia (3.2%). The frequency of severe anaemia was 39.8% in children of six to 24 months of age and 25.9% in children of 25-60 months of age. More children (8.7%) in the 25-60 months age group had cerebral malaria compared with 4.4% in the 6-24 months age group. The overall case fatality ratio was 3.5%. Cerebral malaria and hyperlactataemia were the significant risk factors associated with death. Severe anaemia, though a major presentation, was not significantly associated with risk of death.


CONCLUSIONS
Severe malaria is a frequent and seasonal childhood disease in northern Ghana and maybe an adequate endpoint for future malaria vaccine trials.
Navrongo Health Research Centre, Navrongo, Ghana. aroduro@yahoo.com
Abraham R
AR
Oduro
Kwadwo A
KA
Koram
William
W
Rogers
Frank
F
Atuguba
Patrick
P
Ansah
Thomas
T
Anyorigiya
Akosua
A
Ansah
Francis
F
Anto
Nathan
N
Mensah
Abraham
A
Hodgson
Francis
F
Nkrumah
D000367:Age Factors; D000704:Analysis of Variance; D000740:Anemia / Q000209:etiology / Q000401:mortality; D000818:Animals; D002675:Child, Preschool; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D016779:Malaria, Cerebral / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D016778:Malaria, Falciparum / Q000150:complications* / Q000453:epidemiology*; D011379:Prognosis; D012120:Respiration Disorders / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D012621:Seasons; D015996:Survival Rate