title: Detection of malaria in relation to fever and grade of malnutrition among malnourished children in Ethiopia.
abstract: METHODS
  Forty-eight nutritional rehabilitation centres in southern Ethiopia.
  
  
  OBJECTIVE
  To determine 1) the frequency of temperature recording under programme conditions, 2) the proportion of malnourished children with and without fever who had falciparum malaria and 3) the association between malaria and grade of malnutrition.
  
  
  METHODS
  This was a retrospective analysis of routine programme data.
  
  
  RESULTS
  Of 19 200 malnourished children, 16 716 (mean age 4.4 years, 7412 males) underwent a rapid malaria diagnostic test (Paracheck Pf (®)). Malnutrition was graded as severe (38%), moderate (35%) and mild (27%). Temperature was not recorded in 15 248 (91%) children. Malaria was diagnosed in 57 (28%) children with fever (n = 206) and 122 (10%) children with no fever (n = 1262). The prevalence of falciparum malaria was 9%. Malaria prevalence was significantly associated with grade of malnutrition: Paracheck Pf was positive in respectively 5%, 8% and 10% of children with mild, moderate and severe malnutrition (χ(2) for trend 78, P < 0.001).
  
  
  CONCLUSIONS
  This study shows the value of routine malaria screening in malnourished children, especially those with more severe grades of malnutrition, irrespective of fever. Operational shortcomings are highlighted and ways forward to address these problems are discussed.
authors.affiliation: Médecins Sans Frontières, Addis Ababa, Ethiopia.
authors.forename: M
authors.initials: M
authors.lastname: Khogali
authors.affiliation: Medical Department (Operational Research Unit/Operations), Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.affiliation: Médecins Sans Frontières, Addis Ababa, Ethiopia.
authors.forename: A
authors.initials: A
authors.lastname: Keiluhu
authors.affiliation: Médecins Sans Frontières, Addis Ababa, Ethiopia.
authors.forename: K
authors.initials: K
authors.lastname: Van den Brande
authors.affiliation: Medical Department (Operational Research Unit/Operations), Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
authors.forename: K
authors.initials: K
authors.lastname: Tayler-Smith
authors.affiliation: Medical Department (Operational Research Unit/Operations), Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
authors.forename: L
authors.initials: L
authors.lastname: Ayada
authors.affiliation: Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia.
authors.forename: D
authors.initials: D
authors.lastname: Jima
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: S G
authors.initials: SG
authors.lastname: Hinderaker
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
keywords: Ethiopia; malaria; malnutrition; rapid diagnostic test; temperature