Blood Films For Malaria Parasites Research Articles

Sero-prevalence of malaria and the knowledge, attitudes and practices relating to the prevention of malaria among indigenous people living in the central forest spine in Peninsular Malaysia: a mixed-methods study

BackgroundMalaria is still a major public health threat in some parts of the world. Many countries are targeting to achieve malaria free status country. This study aimed to determine the sero-prevalence of malaria and the knowledge, attitudes and practices relating to the prevention of malaria among the indigenous adults living in the central forest spine in Peninsular Malaysia.MethodsA mixed method study was conducted in indigenous settlements in 2020. Blood film for malaria parasite (BFMP) was used to diagnose malaria in this study. A structured questionnaire was used to collect data from the participants. For the qualitative data, in-depth interviews were conducted and data was collected until data saturation was reached. Multiple linear regression was used to determine the predictors after adjusting for confounders. A p-value of < 0.05 is considered as statistically significant. Meaningful statements from the in-depth interviews were assigned to the relevant codes using NVivo version 12 software.ResultsA total of 284 indigenous people participated in the study. The prevalence of malaria in this study was 0%. Those in the middle age group between 25 and 41 years and tested positive for malaria previously were significantly more likely to have better knowledge and attitude scores. Significant correlations were also observed between knowledge-attitude and knowledge-practice. For the qualitative results, most of the respondents were unsure of monkey malaria, but all were aware of human malaria.ConclusionThe present study highlighted the absence of malaria in the study population and relatively good knowledge, attitudes and practices relating to the prevention of malaria.

Prevalence and associated factors of malaria in Pushparajgarh block of district Anuppur, Madhya Pradesh, India

Background: The current study aimed to determine the prevalence of malaria and its association with seasonality of malaria and socio-demographic variables in a tribal dominated district Anuppur (Madhya Pradesh).Methods: This cross-sectional study was based on blood films for malaria parasites (BFMP) data obtained from primary health centers, sub-health centers, community health centers and district hospital. This study was also based on household survey for information on malaria awareness and type of treatment preferred for malaria. From 2014-2016, a household survey was conducted regarding the type of treatment available, assessment of the influence of demographic factors, knowledge, awareness and education on malaria occurrence. Odds ratio were used to analyse the association between the gender, age group, season and types of malaria infection.Results: Annual blood examination rate (11.81%) and slide vivax rate (0.66%) was highest in 2016. There was decrease in slide falciparum rate in 2016 (1.52%). Slide positivity rate was 3.78%, 3.73% and 2.74% in the years 2014-16. Annual parasite incidence rate was 3.20%, 3.82% and 3.07% in the years 2014-16. Plasmodium falciparum positivity rate was 78.13%, 78.17% and 54.49% in the study years and was highest among the females and in the age group of 26 years and above. Distinct seasonality was observed correlating with population dynamics of the vector and climatic and socio-demographic conditions.Conclusions: The prevalence of malaria in tribal dominated Pushparajgarh area showed seasonality that was governed by mosquitogenic factors, their transmission and socio-demographic status of the population.

Placental Malaria histological features and the burden of congenital malaria among HIV/ malaria co-infected mothers in Benin City, Edo State

Background: It is well documented that sub-Saharan Africa bears the highest burden of both malaria and HIV. Coinfection with both diseases is also well documented. Malaria parasites infecting the placenta lead to inflammation, intervillous fibrin deposition and infarction. This pathologic effect of malaria on the placental has led to the staging of placental malaria histology. These pathologic features may reflect different levels in the breach of the integrity of the placenta which may predispose to transmission of congenital malaria and possibly HIV. But few if any have examined the association of maternal placental malaria histology stages in HIV positive and negative mothers and the effects of these on their newborns (congenital malaria). Methods: Subjects were 162 newborns of HIV/malaria co-infected mothers and Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy. Results: The placental malaria histology in HIV positive mothers were predominantly the chronic type (51.9%) and past type (54.6%) in HIV negative mothers respectively. Congenital malaria was significantly more in chronic types of placental malaria histology irrespective of maternal HIV status (p=0.017 in subjects and p= 0.000 in controls respectively) Conclusion: Babies born to mothers are at increased risk for congenital malaria if their placental malaria histology is of the chronic type compared to the other types (active and past) irrespective of maternal HIV status. This risk (chronic type) is highest in mothers with HIV; therefore, all babies born to HIV positive mothers should be screened for congenital malaria and managed as appropriate.

Demographic, clinical and laboratory features of leptospirosis-malaria co-infections in Peninsular Malaysia.

Introduction. Co-infection of leptospirosis-malaria is not uncommon due to their overlapping geographical distribution in the tropics.Aim. This study aimed to describe and compare the demographic, clinical and laboratory features of leptospirosis-malaria co-infection (LMCI) against leptospirosis mono-infection (LMI) in Peninsular Malaysia.Methodology. Data of patients admitted to various hospitals in Peninsular Malaysia from 2011 to 2014 diagnosed with leptospirosis in our laboratory were obtained from their admission records. Co-infections with malaria were identified via blood film for malaria parasites (BFMP). Description with inferential statistics analysis and multiple logistic regressions were used to distinguish features between dual and mono-infections.Results. Of 111 leptospirosis-positive patients, 26 (23.4 %) tested positive for malaria. Co-infections were predominant among male patients with a mean age of 33 years and were prevalent among immigrant populations who had settled in high-density suburban areas. Chills and rigor with splenomegaly were the only significant distinguishing clinical features of LMCI while leukocytosis and raised transaminases were significant laboratory parameters. Only chills and rigor demonstrated a predictive value for LMCI from analysis of multiple logistic regressions. No death was attributed to co-infection in this study, in contrast to LMI (11.8 %, n=10).Conclusion. The significant prevalence of LMCI found in this study with overlapping demographic, clinical and laboratory parameters makes diagnosis of co-infection challenging. It is essential to evaluate co-infection in endemic areas. Strengthened awareness of LMCI, comprehensive diagnostic services and further prospective studies are warranted.

Malaria induced sudden sensorineural hearing loss: a rare presentation

&lt;p&gt;Sudden Hearing loss has been rarely reported as a presenting symptom of malaria fever. It’s even more rare to have a bilateral profound sudden sensorineural hearing loss. A 19 years old female student presented with fever, body weakness, hearing loss with tinnitus. Laboratory investigations done were essentially normal except blood film for malaria parasite which showed a high concentration of the parasite in blood on both occasions. Otoacoustics emission test was passed bilaterally while auditory steady state response showed profound hearing loss bilaterally. Normal hearing was restored within 48 hrs of commencement of anti-malaria drugs and low dose steroids. &lt;/p&gt;

Cotransmission of Malaria and HIV to Infants of Mothers Coinfected With Malaria and HIV in the HAART Era in Benin City, Nigeria.

Malaria and HIV are vertically transmitted to infants. In an era where specific interventions are available to reduce the burden of malaria in pregnancy and vertical transmission of HIV, we examined the transmission and cotransmission of HIV and malaria to infants of mothers coinfected with malaria and HIV. A cross-sectional analytic study performed on 101 HIV/malaria-coinfected mothers and their infants for whom DNA polymerase chain reaction results were available. Blood film for malaria parasites was performed on cord blood and peripheral blood on days 1, 3, and 7 in the newborns. Maternal peripheral blood film for malaria parasite was performed at delivery, and placental tissue was obtained for confirmation of placental malaria by histology. All infants received DNA polymerase chain reaction testing for HIV at 6-8 weeks of life. Cotransmission of malaria and HIV occurred in 2 (1.98%) infants. Vertical transmission of HIV occurred in 7 (7%) babies, whereas congenital malaria was present in 32 (31.7%) babies. The transmission of HIV and presence of congenital malaria were not significantly associated with each other P = 1.000. Of the 88 babies of mothers who commenced highly active antiretroviral treatment (HAART) before pregnancy, 5 (5.7^) had HIV, which was significantly less than 2 (40%) of 5 babies of mothers who commenced HAART during pregnancy P = 0.04. Among mothers coinfected with malaria and HIV, vertical transmission of malaria and HIV was not associated with each other. HAART reduces vertical transmission of HIV especially if started before pregnancy.

Malaria in immuno-suppressed individuals on antiretroviral therapy (ART) in north-central Nigeria

The immune deficiency caused by HIV infection reduces the immune response to malaria parasitaemia and therefore leads to an increased frequency of clinical attacks of malaria. The burden of malaria in HIV-infected adults on antiretroviral therapy (ART) was determined and the association between immunological status of these HIV-infected individuals with malaria parasite was investigated. One hundred and twenty blood samples were collected from HIV infected adult volunteers on ART in Abuja and its surrounding communities. Demographic information as well as weight of participants were obtained. Blood samples were subjected to thick and thin blood films for malaria parasites and CD4 cell count quantification. Hematological parameters such as PCV, WBC and differential counts were also obtained from these blood samples. Malaria was diagnosed in 51 (42.5%) out of the 120 volunteers. Lower CD4 cell counts were associated with increased rate of malaria which was 44.1% at CD4 cell count of ≤ 200 cells/ μ L and 40.4% at >200 cells/ μ L (p<0.05). Hematological parameters also showed significant relationship at p <0.05. Severely immuno-suppressed HIV infected patients are at greater risk of malaria infection, hence the need for a more aggressive malaria control measures especially among these group of individuals. Keywords: HIV; immuno-suppressed; ART; malaria

Assessment of the Prevalence of Anaemia and Associated Risk Factors among Children Under Five Years in rural communities ofthe Hohoe Municipality, Ghana

Background:Anemia in children continues to be a major public health challenge in most developing countries.This study determined the prevalence of anaemia and its associated risk factors among children under five in four rural communities in the HohoeMunicipality.Method: A descriptive community-based cross-sectional study was carried in November 2015. Interviews with semi-structured questionnaires were used to obtain information from mothers of childrenon socio-demographic characteristics, dietary and feeding practices of the children. Axillary temperature and anthropometric indices were measured using standard methods. Finger-prick blood samples were collected for Haemoglobin concentration measurement and blood film for malaria parasites. Chi-squared test and logistic regression were used to determine theassociation between dependent and independent variables. Results:Of the 235 children surveyed, 113 (48.1%) were anaemic (Hb<11.0g/dl) and17 (7.2%) had low Haemoglobin (Hb< 8.0g/dl). Malaria prevalence by microscopy was 40 (17.0%) andlong-lastinginsecticide-treatednet (LLIN) usage was 173 (73.6%). Anaemia was significantly higher among children aged 6-23 months than those aged 24-59 months (I‡2 =4.91, p=0.027).Children of mothers aged between 40-49 years  were 84%  times less likely to have anaemia as compared to those aged less than 30 years (AOR=0.16, p=0.005). Children who tested negative for malaria were 75% times less likely to have anaemia (AOR=0.25, p<0.001).No significant difference was observed between males and females, LLIN usage and consumption of iron, vitamin B12, folate and anaemia. Conclusion:Anaemia prevalence in the rural HohoeMunicipality is relatively low compared the 74% reported bythe Ghana Demographic Health Survey in 2014 for rural Ghana. Age of mother and malaria parasitaemia were factorsfound to be contributing significantly toanaemia. Future interventions should include promotion of foods containing iron, Vitamin B12 and folate, continuous use of LLIN and intermittent preventive treatment of asymptomaticmalaria.

A COMPARISON OF RAPID DIAGNOSTIC TESTING (BY PLASMODIUM LACTATE DEHYDROGENASE), AND QUANTITATIVE BUFFY COAT TECHNIQUE IN MALARIA DIAGNOSIS IN CHILDREN.

Background:The World Health Organization (WHO) considers early and rapid diagnosis as one of the strategies to control malaria. This study compared the performance of Quantitative Buffy Coat (QBC) test and the Plasmodium lactate dehydrogenase (pLDH) rapid diagnostic test (RDT) with microscopy as the gold standard.Materials and Methods:The study involved children ages 0-5 years who presented with a history of fever at the University College Hospital, Ibadan, Nigeria. Blood was collected from each patient and used for RDT, QBC and Giemsa-stained blood films for malaria parasites (MP). Results of QBC and RDT were compared with microscopy results for the diagnosis of malaria.Results:A total of 370 cases (194 boys and 176 girls) were studied giving a male: female ratio of 1.1:1. Of the 370 cases tested using Giemsa-stained thick blood films for MP, 78 (21 %) were positive. For the QBC test, 78 (21%) of the cases were positive with sensitivity, specificity, positive and negative predictive values of 70.5 %, 92.1%, 70.5 % and 92.1 % respectively. Seventy-six (20%) of the cases were positive by RDT with sensitivity, specificity, positive and negative predictive values of 84.2 %, 95.2 %, 82.1 %, and 95.9 % respectively. There was no significant difference in the sensitivity of QBC compared with the RDT.Conclusion:Both the QBC and the pfLDH (RDT) performed reasonably well in this study Malaria rapid diagnostic tests are recommended in malaria endemic clinical settings to avoid unnecessary antimalarial treatment.List of Abbreviations: AO: Acridine orange, AIDS: Acquired immunodeficiency syndrome, ACT: Artemisinin-based combination therapy, CM:Cerebral malaria, BCP:Benzothiocarboxypurine, DDT:Dichloro-diphenyl-trichloroethane, DNA:DeoxyriboNucleic Acid, ELAM-1: Endothelial leukocyte adhesion molecule, G6PD: Glucose-6-Phosphate Dehydrogenase, HIV: Human immuno deficiency virus, HRP 2: Histidine Rich Protein 2, ICAM -1: Inter cellular adhesion molecule1, ICER: Incremental cost effectiveness ratio, IL-1: Interleukin -1, IFN-g: Interferon-gamma, IgG: Immunoglobulin G, MP: Malaria parasite, NADP: Oxidised Nicotinamide Adenine Dinucleotide Phosphate, NADPH: Reduced Nicotinamide Adenine Dinucleotide Phosphate, PCV: Packed Cell Volume (haematocrit), P. falciparum: Plasmodium falciparum, PLDH: Plasmodium lactate dehydrogenase, PCR: Polymerase Chain Reaction, PPV: Positive predictive value, QBC: Quantitative Buffy Coat examination, TNF: Tumour necrosis factor, NPV: Negative predictive value, RDT: Rapid diagnostic test, SP: Sulphadoxine -Pyrimethamine, SMA: Severe malarial anaemia, UM: Uncomplicated malaria, USA:United States of America, VCAM-1: Vascular cell adhesion molecule, WBC: White Blood Cell, WHO: World Health Organization.

Prevalence of congenital malaria in newborns of mothers co-infected with HIV and malaria in Benin city

Background: HIV and Plasmodium falciparum malaria co-infection annually complicates about one million pregnancies in sub-Saharan Africa. Congenital malaria (CM) has deleterious effects on newborns. Little is known about the effect of co-infections on the prevalence of CM in infants born by these women. This study was carried out to determine the prevalence of CM in newborns of mothers co-infected with HIV and malaria compared to HIV-negative mothers with malaria in Benin-City.Methods: Subjects were 162 newborns of mothers co-infected with HIV and malaria. Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy.Results: The prevalence of CM in subjects was significantly higher than in controls (34.6% and 22.2%, p=.014). Profound immunodepression (maternal CD4 cell count <200 cell/mm3) was significantly associated with CM (p=.006). The major predictors of CM in subjects were maternal CD4 cell count <200 cell/mm3 and placental malaria while in controls placental malaria was the only predictor.Conclusions: Babies born to mothers co-infected with HIV and malaria are at increased risk for CM. All babies born by HIV positive mothers should be screened for CM.

Factors Associated with Malaria Prevalence among Children under Five Years in the Hohoe Municipality of Ghana

Background: Malaria continues to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission and malaria is still the leading cause of morbidity and mortality among children under five years. This study was set out to determine factors associated with malaria infection among children less than five years. Method: An unmatched case-control study was conducted in November 2015 involving children less than five years from 30 communities. Information on the background characteristics of the children and parents/guardians were collected using a pretested questionnaire. Children were screened to determine their malaria infection status using finger prick blood for RDT. Anthropometric indices and axillary temperature were measured, as well as blood film for malaria parasites and haemoglobin levels. T-test was used for means and Odds Ratios was used to determine the relationships and associations between the dependent and independent variables. Results: Out of 1697 children screened, 676 (39.8%) tested positive with RDT (cases) and 1,021 tested negative (controls). Older children aged 24-35 and 36-47, and 48 months and above were more likely to have malaria as compared to the younger age group 6-11 months (OR=1.66 (95% CI: 1.04-2.65); p=0.034), (OR=1.77 (95% CI: 1.10-2.87); p=0.019) and (OR=2.02 (95% CI: 1.24-3.29); p=0.005), respectively. Current fever, History of fever within one week and antimalarial drug use at home were 3.07, 1.75 and 4.03 times more likely to occur among cases than in the controls (OR=3.07 (95% CI: 1.21-7.81); p<0.018), (OR=1.75 (95% CI: 1.29-2.37); p<0.001) and (OR=4.03 (95% CI: 2.82-5.77); p<0.001), respectively. Anaemia (HB<11.0g/dL) was 1.87 times more likely among the cases than in the controls (OR=1.87 (95% CI: 1.40-2.48); p<0.001). Children of parents/guardians who were farmers and traders were more likely to have malaria (OR=1.73 (95% CI: 1.16-2.56); p=0.007) and (OR=1.83 (95% CI: 1.22-2.74); p=0.003), respectively. Conclusion: Age, current fever, history of fever within one week, anaemia, use of antimalarial drugs at home and parent/guardian’s occupation were factors associated with malaria infection. Targeted screening and treatment of older children and intensive education on malaria prevention in addition to the current control activities could serve as tools for controlling malaria to the level of elimination.

Prevalence of anaemia among Quranic school (Khalawi) students (Heiran)in Wad El Magboul village, rural Rufaa, Gezira State, Central Sudan: a cross sectional study.

IntroductionThis is a cross sectional descriptive community-based study. The aim was to assess the prevalence of anaemia among quranic schoolchildren in khalawi Wad EL Magboul village, rural Rufaa, Gezira State, central Sudan.MethodsA sample of 180 male participants were included in the study. Informed consent was obtained. Venous blood samples were obtained to measure the hematological parameters and blood films for malaria parasites. Urine and stool analyses were also done. Data were analyzed using SPSS.ResultsThe mean age of participants was 12.31 years (SD +/- 2.26). The mean Hb value was 11.75g/dl and it was statistically significant correlation when compared with the mean Hb reference value (13.5g/dl) P value 0,000 (95% CI). Regarding period of stay in the khalwa up to the time of the study, 88 (49.28%) for one year, 54 (30.24%) for 2 years, 22 (12.32%) for 3 years and 16 (8.96%) for more than 3 years. About 77 students (42.78%) were pale on clinical examination. The Mean Cell Hemoglobin (MCH) mean value was 25.58 pg ( 3.55). Many conditions known to be associated with anemia were found; 49 students (27.2%) had a positive blood films for falciparum malaria, 14 students (7.8%) were found to have haematuria and ova of S. haematobium, In169 students (93.4%) stool examination was negative , while 11 students (6.6%) had intestinal worms (Enterobius vermicularis).ConclusionMajority of the study participants had iron deficiency anaemia, followed by haemolytic, macrocytic and sickle cell anaemia. This might have negative health and educational implications.

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Predictors of anemia in pregnancy among pregnant women accessing antenatal care in a poor resource setting in South Eastern Nigeria

Background: Anemia in pregnancy affects about half of pregnant women and constitutes a serious health problem. Objectives: The aim was to determine the prevalence of anemia in pregnancy, as well as its pattern and determinants. Materials and Methods: This was a prospective cross-sectional study conducted at antenatal booking clinic of Federal Teaching Hospital Abakaliki from February to July 2012. Hemoglobin <11 g/dl was regarded as anemia. Estimation of hemoglobin concentration, HIV infection, blood group, genotype and blood film for malaria parasite and erythrocyte morphology were done. Stool analysis was also done. Results: Prevalence of anemia in pregnancy was 58%. Anemia in pregnancy was a common finding among primigravida 82 (66.1%), social Class II 14 (56.0%), social Class III 98 (53.6%), social Class IV 45 (61.6%), social Class V 117 (65.4%), antenatal booking at 14–27 weeks 211 (70.3%), and antenatal booking at ≥28 weeks 47 (74.6%). The significant predictors of anemia in pregnancy include HIV in pregnancy (odds ratio [OR] =4.88 [1.09–21.84]), P = 0.04, obstetric hemorrhage (OR = 2.97 [1.27–6.97]), P = 0.01, malaria parasitemia (OR = 4.28 [2.28–8.03]), P < 0.001, primigravidity (OR = 0.04 [1.03–2.41]), P = 0.04, and helminthiasis (P < 0.001). Conclusion: Anemia is still a common finding in pregnancy, and important contributing factors include malaria parasitemia, helminthic infestation and HIV in pregnancy.

Hematological indices in febrile neonates with malaria parasitaemia in Calabar.

Background:Normal hematological indices has been determined in Nigerian newborns and found to be lower compared to their Caucasian counterparts. This was attributed to genetic factors. Malaria is endemic in Nigeria and is one of the major causes of ill health and death. Anemia is an important manifestation of malaria. Resistance by malaria parasites to antimalarial drug exacerbates the situation by continuous hemolysis.Aim:To determine the hematological indices in febrile newborn with malaria parasitemia.Materials and Methods:One-hundred fifty neonates (0-28 days) with fever admitted into the Newborn Unit of University of Calabar Teaching Hospital, over a 6 months period, were recruited consecutively. Blood film for malaria parasites and samples for full blood count were obtained and sent to the laboratory before commencement of the treatment. Data analysis was with SPSS version 14.Results:One-hundred fifty babies were recruited into the study. Most (85.3%) of the babies were aged ≤7 days. Six babies (4%) had malaria parasitemia. Plasmodium falciparum was the only species identified. All the babies that had parasitemia were anemic (mean hemoglobin [Hb] concentration of 12.6 g/dl) even when parasite count was low (average of 30.6/µl) though this could not be attributed solely to malaria. None of these neonates was transfused. All the other hematological indices were within the normal range of healthy newborn population irrespective of parasitization.Conclusion:Neonatal malaria does occur in our environment. While it does not affect the white blood indices, it lowers neonatal Hb. It is recommended that Hb concentration be estimated in newborns with malaria to reduce infant morbidity and mortality in our environment.

Malaria parasite positivity among febrile neonates

Background: Malaria, earlier considered rare in neonates, has been reported with increasing frequency in the last decade. Neonatal malaria diagnosis is challenging because the clinical features are non-specific, variable and also overlap with bacterial infection.Aim: To determine the prevalence of neonatal malaria and the associatedclinical features in newborn babies with fever.Patients and methods: One hundred and fifty neonates with fever admitted into the Newborn unit of the University of Calabar Teaching Hospital, over a six month period, were recruited consecutively. Symptoms and signs for each neonate were documented. Blood film for malaria parasites and investigation for sepsis workup were done before commencement of drugs.Results: One hundred and fifty babies were recruited. Most (85.3%) of the babies were aged .7 days. One hundred and thirty six (90.7%) of the mothers were booked for antenatal care (ANC). Most of the babies were from primiparous women (54.7%). Six babies (4%) had malaria parasitaemia with four (2.7%) being congenital malaria and two (1.3%)acquired malaria. Plasmodium falciparum was the only species identified. All six with malaria were from the 136 booked mothers. Four of the affected six neonates also had septicaemia. The clinical features in babies with malaria only were, fever, fast breathing and jaundice while thosewith malaria and bacterial co-infection had, in addition, poor suck.Conclusion: Malaria infection and septicemia can coexist in some Nigerian newborns and since the clinical presentation of each of these condition are closely similar, it is recommend that malaria parasite investigation be included as part of the investigation in the newborns with fever. This approach can help to avoid a delay in applying the appropriate therapeuticintervention

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The Impact of Malaria in Pregnancy on Changes in Blood Pressure in Children During Their First Year of Life

We established a maternal birth cohort in Ibadan, Nigeria, where malaria is hyperendemic, to assess how intrauterine exposure to malaria affected infant blood pressure (BP) development. In a local maternity hospital, healthy pregnant women had regular blood films for malaria parasites from booking to delivery. Growth and BP were measured on 318 babies, all followed from birth to 3 and 12 months. Main outcomes were standardized measures of anthropometry and change in BP to 1 year. Babies exposed to maternal malaria were globally smaller at birth, and boys remained smaller at 3 months and 1 year. Change in systolic BP (SBP) during the year was greater in boys than in girls (20.9 versus 15.7 mm Hg; P=0.002) but greater in girls exposed to maternal malaria (18.7 versus 12.7 mm Hg; 95% confidence interval, 1-11 mm Hg; P=0.02). Eleven percent of boys (greater than twice than expected) had a SBP ≥95th percentile (hypertensive, US criteria), of whom 68% had maternal malaria exposure. On regression analysis (β coefficients, mm Hg), sex (boys>girls; β=4.4; 95% confidence interval, 1.1-7.7; P=0.01), maternal malaria exposure (3.64; 0.3-6.9; P=0.03), and weight change (2.4; 0.98-3.8/1 standard deviation score; P=0.001) all independently increased SBP change to 1 year, whereas increase in length decreased SBP (-1.98; -3.6 to -0.40). In conclusion, malaria-exposed boys had excess hypertension, whereas malaria-exposed girls a greater increase in SBP. Intrauterine exposure to malaria had sex-dependent effects on BP, independent of infant growth. Because infant-child-adult BP tracking is powerful, a malarial effect may contribute to the African burden of hypertension.

Malariometric Indices among Nigerian Children in a Rural Setting

Malaria contributes to high childhood morbidity and mortality in Nigeria. To determine its endemicity in a rural farming community in the south-south of Nigeria, the following malariometric indices, namely, malaria parasitaemia, spleen rates, and anaemia were evaluated in children aged 2–10 years. This was a descriptive cross-sectional survey among school-age children residing in a rubber plantation settlement. The children were selected from six primary schools using a multistaged stratified cluster sampling technique. They were all examined for pallor, enlarged spleen, or liver among other clinical parameters and had blood films for malaria parasites. Of the 461 children recruited, 329 (71.4%) had malaria parasites. The prevalence of malaria parasitaemia was slightly higher in the under fives than that of those ≥5 years, 76.2% and 70.3%, respectively. Splenic enlargement was present in 133 children (28.9%). The overall prevalence of anaemia was 35.7%. Anaemia was more common in the under-fives (48.8%) than in those ≥5 years (32.8%). The odds of anaemia in the under fives were significantly higher than the odds of those ≥5 years (OR = 1.95 [1.19–3.18]). Malaria is highly endemic in this farming community and calls for intensification of control interventions in the area with special attention to school-age children.

Malaria and the Use of the Insecticide-Treated Net (ITN) among Under-Five Children in Kuje Area Council of the Federal Capital Teritory Abuja, Nigeria

BACKGROUND: About 29.8 million children under five are at risk of malaria in Nigeria and in most cases the incidence of acute illness is difficult to measure because of the imprecision in clinical diagnosis and lack of microscopic confirmation. The study assessed the effectiveness of the insecticide-treated nets (ITN) in reducing the prevalence of malaria among children under the age of five following free distribution of the ITNs and an intensive health education to the mothers and care givers on the prevention of malaria. METHODOLOGY: It was a community based comparative interventional study that was carried out in Kuje and Rubochi communities of the Federal Capital Territory, Abuja among 232 children under-five years who were selected through a two staged sampling technique. A semi structured interviewer administered questionnaire was used to obtain information from the caregivers and the mothers of the children while blood samples were collected from the children for microscopic examination of thin blood films for malaria parasites after obtaining consent from the mothers and caregivers. Children with malaria were treated at baseline in both the intervention and the control groups and health education was given to the mothers/caregivers after which free ITNs were distributed to the intervention group only. At post intervention, the same health education and free ITN were also given to the caregivers/mothers of the under-five children in the control group after a post intervention assessment was carried out in both groups using the same instruments that were used at pre-intervention. Data collected were collated and analyzed using SPSS version 16 statistical software and results presented using tables with significance of association tested with the Chi square test. The level of significance was set at 95% (p≤ 0.05) for all statistical analysis. RESULT: The mean age of the under five children was 18.4±12 months and 26.7±15 months in intervention and the control groups respectively. Ownership of ITNs increased from 58% to 100% in the study group and from 52.5% to 69.9% in the control group. ITN usage rose from 57% to 83% after the study ( p=0.0000) in the intervention group. In the control, the proportion of under five children sleeping under an ITN also rose from 45.8% to 58.3% but this was not statistically significant (p=0.08943). A 93% reduction in prevalence of malaria (P= 00000) using a thin blood film was recorded in the intervention group. CONCLUSION: This study showed a prevalence of malaria in under- five children of 39.3% in the study group (Kuje) and 22.0% in the control group (Rubochi). Proper use of ITNs was associated with a 93% decline in the prevalence of malaria in the intervention group from 39.3% to 2.7%.