High Prevalence of Malaria Parasitemia and Anemia among Hospitalized Children in Rakai, Uganda

Abstract

BackgroundThere is a paucity of data on malaria among hospitalized children in malaria endemic areas. We determined the prevalence, presentation and treatment outcomes of malaria and anemia among children in two hospitals in Rakai, Uganda.MethodsChildren under five years hospitalized in Kalisizo hospital or Bikira health center in Rakai district, Uganda between May 2011 and May 2012 were enrolled and followed-up until discharge, death or referral. Data were collected on social-demographic characteristics, current and past illnesses and clinical signs and symptoms. Blood smears, hemoglobin (Hgb) levels and HIV testing were performed from finger/heel prick blood. The associations between malaria infection and other factors were estimated using log-binomial regression to estimate adjusted prevalence risk ratios (aPRR) and 95% confidence intervals (CIs), controlling for clustering at health facilities.Results2471 children were enrolled. The most common medical presentations were fever (96.2%), cough (61.7%), vomiting (44.2%), diarrhea (20.8%), and seizures (16.0%). The prevalence of malaria parasitemia was 54.6%. Children with malaria were more likely to present with a history of fever (aPRR 2.23; CI 1.18–4.24) and seizures (aPRR 1.12; CI 1.09–1.16). Confirmed malaria was significantly lower among girls than boys (aPRR 0.92; CI 0.91–0.93), HIV infected children (aPRR 0.60 CI 0.52–0.71), and children with diarrhea (aPRR 0.76; CI 0.65–0.90). The overall prevalence of anemia (Hgb<10 g/dl) was 56.3% and severe anemia (Hgb<6 g/dL) was 17.8%. Among children with severe anemia 76.8% had malaria parasitemia, of whom 93.1% received blood transfusion. Malaria associated mortality was 0.6%.ConclusionThere was a high prevalence of malaria parasitemia and anemia among inpatient children under five years. Malaria prevention is a priority in this population.

Epidemiological Study of the Association Between Malaria and Helminth Infections in Nigeria

“…This difference was borderline significant. This is not in agreement with a study in Uganda, 15 which showed that confirmed malaria was lower among girls (52.3%) than boys (57.3%), and it had no bearing on the effect of helminth coinfection (data not shown).…”

Prevalence and trend of malaria with anaemia among under-five children in Jasikan District, Ghana

“…Significant reductions in anaemia prevalence have been achieved or recorded following malaria control programs in endemic areas. Low prevalence of anaemia found in this study differs with that of Kiggundu et al (2013) who reported a high prevalence of anaemia (56.3%) among children under-five in Southwestern Uganda [26]. Furthermore, this finding contrasts a higher prevalence of anaemia among children under-five years in Navrongo, Northern part of Ghana [10].…”

“…The Jasikan District situated in the Volta Region of Ghana is located in the malaria-endemic zone and might have contributed to the increased proportion of malaria with anaemia cases as compared to Western Ghana. On the contrary, this finding is comparatively lower than the 76.8% prevalence reported in children under-five years from a survey conducted in Southwestern Uganda [26]. Higher prevalence reported in Uganda could be attributed to multifactorial causes such as hookworm and nutritional deficiencies including the location of the district in a malaria-endemic zone.…”

Prevalence and genetic diversity of Plasmodium falciparum in patients attending regional health center in Daloa, Cte dIvoire

“…Malaria, a disease caused mainly by Plasmodium falciparum, is a major public health concern in sub-Saharan Africa (Menard et al, 2013). All age groups are affected but the most vulnerable are children aged five years and below, pregnant women and people living with HIV/AIDS (Kiggundu et al, 2013). Many studies have shown that malaria is influenced by the environment such as climate change and is often linked to developmental projects of hydro-agricultures whose implementation disregards their impacts on malaria transmission (Koudou et al, 2007).…”