Malaria and COVID-19 prevalence in a population of febrile children and adolescents living in Libreville

Abstract

Background: Patients with acute febrile illness need to be screened for malaria and coronavirus disease 2019 (COVID-19) in malaria-endemic areas to reduce malaria mortality rates and to prevent the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Objectives: To estimate the frequency of children and adolescents with COVID-19 and/or malaria among febrile patients attending for malaria diagnosisMethod: This cross-sectional study was conducted in a sentinel site for malaria surveillance during the SARS-CoV-2 pandemic (Omicron variant), from October 2021 to December 2021 in Gabon. All febrile patients were tested for malaria using microscopy. Severe acute respiratory syndrome coronavirus 2 was detected by real time polymerase chain reaction (RT-PCR) and rapid antigen tests developed by Sansure Biotech®.Results: A total of 135 patients were screened. Their median age was 6 (interquartile range [IQR]: 3–14) years. Malaria was confirmed for 49 (36.3%) patients, 29 (32.5%) children, 13 (59.0%) adolescents and 7 (29.2%) adults. The frequency of COVID-19 cases was 7.4% (n = 10/135), and it was comparable between children (n = 6; 6.7%), adolescents (n = 2; 9.1%) and adults (n = 2; 8.3%) (p = 0.17). Malaria and COVID-19 co-infections were diagnosed in 3 (6.1%) patients from all the age groups. Participants with a co-infection had a higher median temperature, a higher median parasitaemia, and were mostly infected with non-falciparum malaria.Conclusion: COVID-19 cases and cases of malaria/COVID-19 co-infections were found in febrile children and adolescents. SARS-CoV-2 testing should be included in the screening of suspected malaria cases.Contribution: This study highlights the presence of malaria-COVID-19 coinfection among children and adolescents who should also be screened for both diseases, like for adults.

Outcomes of childhood severe malaria: a comparative of study pre-COVID-19 and COVID-19 periods

“…In addition, a few of the children may have missed co-infections, which probably contributed to the increased severity of their illness and the poorer outcomes obtained in this study. However, it is worthy of note that a few studies also observed no increased mortality in the presence of co-infection, which calls for further study [ 31 , 32 ]. The import of our findings of a higher death rate in this study shows that the deaths from severe malaria during COVID-19 may be far higher than reported, hence the need for a review of the country data, especially at the tertiary health facilities that manage the most complicated forms of malaria in Nigeria.…”

Prevalence of Malaria and COVID-19 Coinfection: A Systematic Review and Meta-Analysis

“…Although there were studies in the pediatric population, the highest number of cases of coinfection was in people between 0-30 years old and in those over 50 years old. The scope of coinfection in the pediatric population is possible due to the endemic malaria zones distributed in some sub-Saharan African countries (21), reaching up to 6.1% (25).…”

“…Thirteen cross-sectional studies were included on the coinfection between Malaria and COVID-19, published between 2020 and 2022 (Table 3) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The total reported population was 7818 patients, of which our sample consisted of 2523 patients diagnosed with COVID-19, distributed across nine countries: Nigeria (n = 475) (15,17,18), Democratic Republic of Congo (n = 160) (16), India (n = 494) (19,20), Uganda (n = 597) (21), Sudan (n = 747) (22,23), China (n = 4) (24), Gabon (n = 10) (25), Burkina Faso (n = 32) (26), and Angola (n = 4) (27).…”

“…Additionally, coinfection between Malaria and COVID-19 was reported in 879 patients. The diagnostic methods used for Malaria and COVID-19 were microscopy and reverse transcriptase polymerase chain reaction (RT-PCR), respectively (Table 3) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The pooled prevalence of coinfection between Malaria and COVID-19 was 45% (95% CI: 16, 76) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

“…The diagnostic methods used for Malaria and COVID-19 were microscopy and reverse transcriptase polymerase chain reaction (RT-PCR), respectively (Table 3) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The pooled prevalence of coinfection between Malaria and COVID-19 was 45% (95% CI: 16, 76) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The study with the lowest proportion was conducted in the Democratic Republic of Congo with a prevalence of 1% (95% CI: 0, 2) (16), while the highest was conducted in Nigeria with a prevalence of 100% (95% CI: 100, 100) (18).…”