Abstract
The prevalence and pattern of presentation of severe malaria differ from one area to another, in one age group and gender. A descriptive cross sectional study of children between the ages of one month and fourteen years with symptoms of severe malaria was conducted between July and December 2018 in Dutse and Birnin Kudu Local Government Area of Jigawa State. Venous blood samples were used for parasitological, hematological and biochemical examination following standard procedures. Thick and thin blood films were prepared, stained and examined at x100 magnification. A total of 172 children were considered in which, 73/167(43.7) children had severe malaria. Children less than 5 years of age had the highest percentage of severe malaria (47.1%; 95% CI = 39.5 to 54.7). Hyperpyrexia, prostration, hyper parasitemia and multiple convulsions were the commonest presentations. While metabolic acidosis, jaundice, hypoglycemia and respiratory distress were the least presenting features, no child presented spontaneous bleeding or shock. Furthermore, 21/73 children with severe malaria had only one feature of severity, 32/73 (43.8) had two features of severity, while 14/73 (19.2) of the children had up to three features. Only 4/73 (5.5) children had four of the features of severity. Chi-square analysis showed significant difference (P <0.05) in prostration and multiple convulsions among children less than and above 5 years. The prevalence of severe malaria in less than five years old is high; hence care givers should present symptoms early to the hospital in order to prevent progression to severe life threatening malaria.
Highlights
Malaria is older than recorded history and probably plagued prehistoric man and is said to have been ravaging humanity for decades (Cox, 2010).It is a mosquito - borne protozoan infection of the red blood cells transmitted by the bite of a female anopheline mosquito.The primary vector across most of the country is Anopheles gambiae s.s, because of its high resistance to insecticides and profound adaptation to different climatic conditions (White, 2010)
Children under five years accounted for 67%of all malaria deaths and the WHO African Region accounted for 95% of the deaths with Nigeria (23%), Democratic Republic of the Congo (11%) contributing the most (WHO, 2000)
The cost of daily labour coupled with cost of treatment and high mortality associated with the disease make malaria one of the main diseases retarding development in Africa (Ekpenyong and Eyo, 2008).Severe malaria is acute complicated malaria with signs of organ dysfunction and/or high level of parasitaemia associated with high mortality (White et al, 2014).The 2000, WHO criteria for diagnosis of severe malaria includes clinical manifestations and laboratory parameters(WHO, 2000).Studies on African children have centered mostly on the clinical manifestations and factors related to prognostication like genotype, nutrition, blood group etc, but the prevalence, nature and pattern of severity, has been mostly retrospective studies with considerable impact on the outcome (Von Seidlein et al,. 2012).FUDMA Journal of Sciences (FJS) Vol 5 No.2, June, 2021, pp 511- 518
Summary
Malaria is older than recorded history and probably plagued prehistoric man and is said to have been ravaging humanity for decades (Cox, 2010).It is a mosquito - borne protozoan infection of the red blood cells transmitted by the bite of a female anopheline mosquito.The primary vector across most of the country is Anopheles gambiae s.s, because of its high resistance to insecticides and profound adaptation to different climatic conditions (White, 2010). This cross – sectional descriptive study was carried out to assess the prevalence and pattern of severe malaria parasite infection among children admitted into the Emergency Paediatric Unit of General Hospitals Dutse and Birnin kudu in Jigawa state.
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