Prevalence and risk factors of malaria among children in southern highland Rwanda

Abstract

BackgroundIncreased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare (altitude, 1,768 m), a combined community-and facility-based survey on Plasmodium infection was conducted early in 2010.MethodsA total of 749 children below five years of age were examined including 545 randomly selected from 24 villages, 103 attending the health centre in charge, and 101 at the referral district hospital. Clinical, parasitological, haematological, and socio-economic data were collected.ResultsPlasmodium falciparum infection (mean multiplicity, 2.08) was identified by microscopy and PCR in 11.7% and 16.7%, respectively; 5.5% of the children had malaria. PCR-based P. falciparum prevalence ranged between 0 and 38.5% in the villages, and was 21.4% in the health centre, and 14.9% in the hospital. Independent predictors of infection included increasing age, low mid-upper arm circumference, absence of several household assets, reported recent intake of artemether-lumefantrine, and chloroquine in plasma, measured by ELISA. Self-reported bed net use (58%) reduced infection only in univariate analysis. In the communities, most infections were seemingly asymptomatic but anaemia was observed in 82% and 28% of children with and without parasitaemia, respectively, the effect increasing with parasite density, and significant also for submicroscopic infections.ConclusionsPlasmodium falciparum infection in the highlands surrounding Butare, Rwanda, is seen in one out of six children under five years of age. The abundance of seemingly asymptomatic infections in the community forms a reservoir for transmission in this epidemic-prone area. Risk factors suggestive of low socio-economic status and insufficient effectiveness of self-reported bed net use refer to areas of improvable intervention.

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

“…It was found that older children 24 months and above were more likely to have malaria when compared to children aged 6-11 months. This is similar to other studies, which indicated that an older child was associated with a higher risk of malaria [7,10,11]. Age of child could also contribute to the individual's way of life, where older children could move about freely and may go outside more often and therefore may be more susceptible to mosquito bites, and thus malaria.…”

Socioeconomic development as an intervention against malaria: a systematic review and meta-analysis

“…20 records met our inclusion criteria (table), [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] and of these 15 contained the necessary data for inclusion in the quantitative analysis (meta-analysis). Five records were excluded from the quantitative analysis either because Bayesian credible intervals were reported (n=2) or because ORs could not be calculated from the available data (n=3)[A: sentence correct as edited?].…”

No Association of the p53 Codon 72 Polymorphism with Malaria in Ghanaian Primiparae and Rwandan Children

“…Arg allele frequencies (Ghana, 0.30; Rwanda, 0.31) and genotypes did not differ between P. falciparum infected and non-infected subjects. Adjusting for the age difference between infected and non-infected individuals and for further associated factors, 8,9 the lack of association between TP53 genotypes and P. falciparum infection remained (data not shown). Likewise, there was no association between genotypes and peripheral blood geometric mean parasite density (/μL, 95% confidence interval [CI]), in either pregnant women (Pro/Pro,1,346]; Pro/Arg, 675 168]; Arg/Arg,1,690]; P = 0.52) or in children [1,837 (978-3,449]; 968 [404-2,322]; 6,792 [615-75,062]; P = 0.12).…”

“…8 The second group involved 545 children 5 years of age randomly selected from 24 rural villages in southern highland Rwanda of whom 16.1% were P. falciparum infected (by PCR; 2.9% categorized as symptomatic malaria defined as a positive blood film plus fever, or a history of fever within the preceding 48 hours). 9 All participants (or legal guardians) gave informed consent, and the study protocols were approved by the Committee on Human Research Publications and Ethics, School of Medical Sciences, University of Science and Technology, Kumasi, Ghana, and the National Ethics Committee, Republic of Rwanda, respectively. The DNA was extracted from stabilized blood samples (AS1 and QIAmp DNA Blood Mini Kit; Qiagen, Hilden, Germany).…”

“…8,9 In brief, 314 primiparous pregnant women were recruited in southern Ghana of whom two-thirds (by polymerase chain reaction [PCR]) had largely asymptomatic placental P. falciparum infection (i.e., only 6.3% of these were febrile), which nevertheless was associated with maternal anemia, low birth weight, and preterm delivery. 8 The second group involved 545 children 5 years of age randomly selected from 24 rural villages in southern highland Rwanda of whom 16.1% were P. falciparum infected (by PCR; 2.9% categorized as symptomatic malaria defined as a positive blood film plus fever, or a history of fever within the preceding 48 hours).…”