Cross-sectional prevalence and pattern of non-anaemia severe malaria among 2–10 year olds in Sokoto in Northwestern Nigeria

Abstract

Malaria is highly prevalent in Nigeria and accounts for approximately 40% of global malaria mortality. However, most reports on severe malaria in Nigeria are from hospital-based studies without accurate information from communities; thus, malaria-related deaths in the community are left untracked. This study aimed to describe the prevalence and pattern of severe malaria in a community in Northwestern Nigeria. A cross-sectional study was conducted among 2–10-year-old children in Sokoto, in August and December 2016, to determine the endemicity of malaria based on Plasmodium falciparum prevalence rate (PfPR2-10) and to describe the disease pattern. Severe malaria was diagnosed according to the World Health Organisation criteria. Data were described using Stata version 15. The prevalence of non-anaemia severe malaria was higher than expected (2.6%), considering the endemicity pattern which was mesoendemic based on a PfPR2-10 of 34.8%. The mean age of children with severe malaria was 3.73 years, and the male–female ratio was 2:1. However, 54.0% of the patients had hyperparasitaemia. A relatively high prevalence of non-anaemia severe malaria was found in Wamakko. This finding suggests the need to identify and treat cases in the community using modifications of current strategies, particularly seasonal malaria chemoprophylaxis.

Keywords

severe malaria / nigeria / malaria mortality / PfPR2-10 / intermediate malaria transmission

References

[1] WorldHealth Organization. World malaria report 2018. Geneva: Switzerland, 2018. xii–xiv

[2] WorldHealth Organization. Severe malaria. Trop Med Int Health 2014; 19(Suppl 1): 7–131

[3] Tusting LS, Rek J, Arinaitwe E, Staedke SG, Kamya MR, Cano J, Bottomley C, Johnston D, Dorsey G, Lindsay SW, Lines J. Why is malaria associated with poverty? Findings from a cohort study in rural Uganda. Infect Dis Poverty 2016; 5(1): 78

[4] Greenwood BM, Bradley AK, Greenwood AM, Byass P, Jammeh K, Marsh K, Tulloch S, Oldfield FSJ, Hayes R. Mortality and morbidity from malaria among children in a rural area of The Gambia, West Africa. Trans R Soc Trop Med Hyg 1987; 81(3): 478–486

[5] Mudenda SS, Kamocha S, Mswia R, Conkling M, Sikanyiti P, Potter D, Mayaka WC, Marx MA. Feasibility of using a World Health Organization-standard methodology for Sample Vital Registration with Verbal Autopsy (SAVVY) to report leading causes of death in Zambia: results of a pilot in four provinces, 2010. Popul Health Metr 2011; 9(1): 40

[6] Nakakana UN, Mohammed IA, Onankpa BO, Jega RM, Jiya NM. A validation of the Malaria Atlas Project maps and development of a new map of malaria transmission in Sokoto, Nigeria: a cross-sectional study using geographic information systems. Malar J 2020; 19(1): 149

[7] WorldHealth Organization. Diagnosis of malaria. In: WHO. Malaria Treatment Guidelines 2015. 3rd ed. Geneva, Switzerland: WHO Press, 2015. 27–31

[8] Okello PE, Van Bortel W, Byaruhanga AM, Correwyn A, Roelants P, Talisuna A, D’Alessandro U, Coosemans M. Variation in malaria transmission intensity in seven sites throughout Uganda. Am J Trop Med Hyg 2006; 75(2): 219–225

[9] Snow RW, Marsh K. The consequences of reducing transmission of Plasmodium falciparum in Africa. Adv Parasitol 2002; 52: 235–264

[10] Idro R, Aloyo J, Mayende L, Bitarakwate E, John CC, Kivumbi GW. Severe malaria in children in areas with low, moderate and high transmission intensity in Uganda. Trop Med Int Health 2006; 11(1): 115–124

[11] O’Meara WP, Bejon P, Mwangi TW, Okiro EA, Peshu N, Snow RW, Newton CRJC, Marsh K. Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya. Lancet 2008; 372(9649): 1555–1562

[12] NationalPopulation CommissionNationalMalaria Control ProgrammeICFInternational. Nigeria Malaria Indicator Survey (MIS) 2010. Abuja, Nigeria. 2012

[13] NationalMalaria Elimination ProgrammmeNationalPopulation CommissionNationalBureau of StatisticsICFInternational. Nigeria Malaria Indicator Survey 2015: Key Indicators. Abuja, Nigeria and Rockville, Maryland, USA. 2016

[14] Jiya N, Sani U. Pattern and outcome of severe malaria among children in Sokoto, North Western Nigeria. WJBiomed Res 2016; 3(1): 6–12

[15] Olanrewaju WI, Johnson AW. Malaria in children in Ilorin, Nigeria. East Afr Med J 2001; 78(3): 131–134

[16] Sowunmi A, Okuboyejo TM, Gbotosho GO, Happi CT. Risk factors for Plasmodium falciparum hyperparasitaemia in malarious children. BMC Infect Dis 2011; 11(1): 268

[17] Théra MA, D’Alessandro U, Thiéro M, Ouedraogo A, Packou J, Souleymane OA, Fané M, Ade G, Alvez F, Doumbo O. Child malaria treatment practices among mothers in the district of Yanfolila, Sikasso region, Mali. Trop Med Int Health 2000; 5(12): 876–881

[18] Okeke TA, Uzochukwu BS. Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria. Malar J 2009; 8(1): 260

Acknowledgements

The staff of Arkilla Primary Health Centre in Wamakko, Sokoto helped with the mobilisation of the community where the study was performed. The study was funded by a dissertation grant from Usmanu Danfodio University Teaching Hospital awarded to UNN to support his Fellowship of the West African College of Physicians in paediatrics. No funding was received for this publication.

Compliance with ethics guidelines

Usman Nasir Nakakana, Ridwan Muhammed Jega, Aliyu Mamman Nauzo, Yahaya Mohammed, and Ismaila Mohammed Ahmed declare that they have no conflict of interest. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all the patients for inclusion in the study. Written informed consent was obtained from the parents or legally accepted representatives of each child included in the study in English or the local language (Hausa). The study was approved by the ethical committees of Usmanu Danfodiyo University Teaching Hospital, Sokoto, and the Sokoto State Ministry of Health. The study was conducted according to relevant guidelines and regulations.

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