Abstract
Malawi is resource poor country in Africa with one of the highest infant and child mortality rates in the world. Malaria is one of the major causes of morbidity and mortality among children in Malawi. Studies have shown barriers to care of sick children and the formal health sector has shown sub-optimal patient assessments and overreliance on antibiotic treatment of a child with fever. In 2017, a team of students from Korea and USA audited clinic registers of six health centres under the hospital’s administration of Kasungu District in Malawi for the year of 2016. The clinics were included in the study were those that contributed to the largest number of patients in the district annually. The aim of the audit was to examine treatment outcomes of all children presenting with fever and on whom a definitive diagnosis or presumptive diagnosis of malaria was made at the 6 chosen clinics in Kasungu for improvement of health information system for the district health office. The number of children with malaria ranged between 80 and 440 per month, with the peak occurring between the rainy months of February to May. Peak mortality rate occurred in September and November at 21%. Patients presented with multiple symptoms of fever, convulsion, pallor, vomiting, cough, diarrhea, abdominal pain and headache. Average mortality rate differed between traditional authorities, ranging from 4% to 15%. Off-season high mortality finding promotes more studies looking into socioeconomic and hospital support. Multiple symptoms among patients treated for malaria is a common finding emphasizing the need to integrate household practices for malaria prevention, good malaria case management and linkage with community care of childhood illness (CCM) programs at the clinics in the district.
Highlights
Malawi is a resource poor country with one of the highest neonatal and infant mortality rates in the world
The monthly incidence rose from January to April, before decreasing from May to July, in consistence with the pattern described in the National Demographic and Health Surveys of Malawi
Our study shows that in Kasungu district of Malawi malaria cases are high among children in the period of January to April which coincides with rainy season when mosquitoes breed in large numbers
Summary
Malawi is a resource poor country with one of the highest neonatal and infant mortality rates in the world. In 2004, a Demographic and Health Survey report showed infant mortality ratio (IMR) of 76 per 1000 live births and a neonatal mortality ratio (NMR) of 27 per 1000 [1]. A similar survey done in 2010 reported that Malaria is endemic throughout Malawi and it is the leading cause of morbidity and mortality in children under age 5 and pregnant women [2]. The report further stated that ninety-eight percent of malaria infections in Malawi are caused by Plasmodium falciparum— with Anopheles funestus, A. gambiae, and A. arabiensis as the primary mosquito vectors. Malaria transmission is largely determined by climatic factors, including temperature, humidity, and rainfall. Vector abundance follows seasonal rainfall patterns, and an increase in temperature raises the parasite’s reproductive rate, thereby influencing the prevalence rate of malaria in the population. Transmission is higher in areas with high temperatures and during the rainy season (October through April), along the lakeshore and lowland areas of the lower Shire Valley, the report concluded
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