ABSTRACT
Background:Malaria is a major cause of fever in endemic countries, although the prevalence of malaria has been declining across Sub-Saharan Africa, the proportion of clinical presentation attributable to febrile illness due to malariato febrile illnesses have remained high. It is therefore important to determine the proportion of fever cases attributable to malaria.Methods:A descriptive cross sectional study was conducted among children aged 1-72 monthspresenting at a tertiary facility in Imo state Nigeria from 1st March, 2014 to 31st October, 2015. Children between 1-72months of age with documented fever at presentation or history of fever in the last 24 hours without signs of severe malaria and thosewithout any history of anti-malarial drugs administration were considered eligible. Fever was regarded as axillary temperature of ≥37.5°C. For all subjects (febrile and afebrile), the presence of Plasmodium falciparum was assessed microscopically by a WHOCertified malaria microscopist. Malaria parasite density was grouped as 1-1000,1001–10000, and >10,000 parasites/μlrespectively according to World Health Organization guidelines for grouping malaria parasitamae while data was analysed using SPSS 20.1v.Results:Overall malaria prevalence of both febrile and afebrile at point of assessment but with history of fever in the last 24 hours was 24.3%. Prevalence by microscopy was 26% among the 289 children who were febrile as at point of examination.There was no significant difference (p>0.05) between malaria prevalence in males as against females. Age group 49-72 months had the highest prevalence (42.6%), while age groups 25-48 and 1-24 months recorded prevalence of 35.7% and 25%, respectively(P<0.05). About 22.5% of afebrile patients had positive Plasmodium parasitaemia. The Geo-mean (range) of parasitaemia was 1427(8-180,000) parasite/μl while mean body temperature ± SD was 37.0±0.9°C. About 8% of the children had high parasite density.Conclusion:Plasmodium falciparum although linked with majority of fever is not the cause of fever in all instances. Healthcare providers should make more effort to correctly diagnose non-malaria febrile cases so as to optimize clinical outcomes for the patients and minimize possible over diagnosis and overtreatment of malaria.
ABSTRACT
A study to establish the prevalence of intestinal helminthiases among schoolchildren of riverine communities in the Ilaje-Ese Odo Local Government Area of Ondo State, Nigeria was conducted. Ninety-four percent of the children studied were infected with intestinal helminths. Trichuris trichiura infection was the commonest (84%), followed by Ascaris lumbricoides (75.3 %) and hookworm (7.6 %). Dual helminthic infections were recorded, with Ascaris-Trichuris having the highest prevalence among the children. Poor environmental sanitation and personal hygiene combined with the absence of potable water and a lack of awareness of the effects of nematode infection were identified as the possible reasons for the high rate of infection. Treatment with albendazole (200 mg) brought about reductions in the level of Trichuris trichiura (to 41.7%), Ascaris lumbricoides (to 4.2%) and Hookworm (to 0.7%). The estimated rates of reduction were 94.4%, 49.7%, and 90.2% for Ascaris lumbricoides, Trichuris trichiura and hookworm respectively. Post-treatment helminthic reduction, as found in this study, is expected to enhance the mental and physical development of the children. Community mobilization with health education messages aimed at improving personal and community hygiene was initiated with an emphasis on creating a sustained reduction in the burden of helminthic infection.