Journal des maladies infectieuses et de la thérapie

Abstrait

Presumptive Diagnosis and Treatment of Malaria in Febrile Children in Parts of South Eastern Nigeria

Okoro CI, Chukwuocha UM, Nwakwuo GC and Ukaga CN

Background: Malaria treatment in Nigeria and other Sub-Saharan Africa is largely based on presumptive diagnosis leading to poor management of non-malaria febrile illness and abuse of antimalarial drugs.

Objectives: To evaluate malaria treatments based on presumptive diagnosis and describe the actual density of uncomplicated malaria among febrile children in South Eastern Nigeria.

Methods: Parasitological diagnosis using microscopy was done among 560 febrile children, 0-12 years attending Paediatric Clinics in a tertiary health facility in the study area. Their blood samples were collected prior to malaria treatment using IMCI guidelines and standard routine clinical practice. These children were grouped into under 5 years and 5-12 years. Data was analysed using SPSS.

Results: Out of 560 children (0-12 years) enrolled in this study, 156(27.9%) were positive for malaria parasites, while 404(72.1%) were negative. Children’s age was significantly related to the prevalence of uncomplicated malaria (p<0.05) and a high determinant in explaining 6.4% of the variance in the prevalence of uncomplicated malaria (F=37.915 and p<0.05). Children 5-12 years (51.9%) had higher parasite density (40,678.2 P/μl) compared to those less than 5. The negative result of 72.1% indicated possibility of overtreatment with antimalarial.

Conclusion: The findings highlight the need for the scaling-up of parasitological confirmation of all malaria suspected cases before treatment with the artemesinin-based combination therapies. Improving the diagnostic system for effective health care delivery in endemic areas will not only provide a good platform for malaria treatment/ monitoring but also reduce rapid onset of drug resistance.