A Study of Childhood Malaria trends at the University of Port Harcourt Teaching Hospital: 2006 – 2018
Main Article Content
Keywords
Malarial disease, severe malaria, Nigeria, decline
Abstract
Background: Several efforts have been put in place to reduce the global burden of malaria especially in children and in sub-Saharan Africa. The study aimed to evaluate the impact of malaria control activities on the trend of childhood malarial diseases at a tertiary hospital in South-south Nigeria.
Methodology: A retrospective review of the case records of all malaria diagnoses including in-patient, out-patient, and emergency room, seen in the Department of paediatrics at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018 was conducted.
Results: There were 41, 863 malaria cases diagnosed over the 12 years with a decline in yearly diagnosis and admissions, from the year 2006 through 2018. Total malaria admissions were 578, (44.5/ year), giving a severe malaria incidence of 1.26%, and there were 164 malaria death cases, with a yearly average of 12. The causes of death in the children with malarial parasitaemia were severe anaemia in 75 (45.7%), hypoglycaemia in 14 (8.5%), cerebral malaria in 17 (10.4%), and prostration with other co-morbidities, 22 (13.4%). Thirty-six children (22%) were convulsing and died soon after admission, with a compounding diagnosis of aspiration and respiratory failure.
Conclusion: There is a gradual reduction in childhood malaria disease, admission, and death, though this is slower than anticipated based on efforts and strategies put in place by the Nigerian government and various organizations.
References
1.Afolabi BM, Sofola OT, Fatunmbi BS, Komakech W, Okoh F, SaliuO, et al. Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria-Niger Delta and Sahel Savannah.Malar J. 2009; 8:1-10
2.Berhe B, Mardu F, Legese H, Negash H. Seasonal distribution and seven-year trend of malaria in NorthWestTigrai: 2012-2018, Ethiopia; 2019. Trop Dis Travel Med Vaccines.2019;5:1 -7
3.World Health Organization. World malaria report. Geneva. 2019. Assessed on January 20th,2019. https://www.who.int/publications/i/item/9789241565721.
4.Adebayo AM, Akinyemi OO, Cadmus EO. Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in southwest Nigeria. J Prev Med Hyg. 2014;55:58-64.
5.Acosta A, Obi E, Ato Selby R, Ugot I, Lynch M, Marie M, et al. Design, Implementation, and Evaluation of a School Insecticide-Treated Net Distribution Program in Cross River State, Nigeria. Glob Health Sci Pract.2018; 6:272-287.
6.Morris A, Ward A, Moonen B, Sabot O, Cohen JM. Price subsidies increase the use of private sector ACTs: evidence from a systematic review. Health Policy Plan. 2015; 30:397-405.
7.Dodo R, Zohoun A, Baglo T, Mehou J, Anani L. Emergency treatment of sickle cell diseases in the Blood Diseases Department at the Koutoukou Maga National Teaching Hospital, Cotonou, Benin. Pan Afr Med J. 2018, Jul 3;30:192.1-9
8.Korenromp E, Mahiané G, Hamilton M, Pretorius C, Cibulskis R, Lauer J, et al. Malaria intervention scale-up in Africa: effectiveness predictions for health programme planning tools, based on dynamic transmission modelling. Malar J.2016; 15:417.1-14
9.Adewemimo A, Kalter HD, Perin J, Koffi AK, Quinley J, Black RE. Direct estimates of cause-specific mortalityfractions and rates of under-five deaths in the northern and southern regions of Nigeria by verbal autopsy interview. PLoS One. 2017; 12:e0178129.
10.Korenromp E, Hamilton M, Sanders R, Mahiané G, BriëtOJ, Smith T, et al. Impact of malaria interventions on child mortality in endemic African settings: comparison and alignment between LiST and Spectrum-Malaria model. BMC Public Health. 2017; 17; 29-42
11.Murray CJ, Rosenfeld LC, Lim SS, Andrews KG, Foreman KJ, Haring D, et al. Global malaria mortality between 1980 and 2010: a systematic analysis. Lancet. 2012; 379:413-431.
12.Bhutta ZA, Sommerfeld J, Lassi ZS, Salam RA, Das JK. Global burden, distribution, and interventions for infectious diseases of poverty. Infect Dis Poverty. 2014; 3: 1-7
13.Thwing J, Eckert E, Dione DA, Tine R, Faye A, Yé Y, et al. Declines in Malaria Burden and All-Cause Child Mortality following increases in control interventions in Senegal, 2005-2010.Am J Trop Med Hyg. 2017; 97:89-98.
14.Yarhere IE, Nte AR. A Ten-year review of all cause paediatric mortality in University of Port Harcourt Teaching Hospital, Nigeria (2006 -2015). Niger J Paediatr. 2018; 45:185 -191.
15.Tobin-West CI, Kanu EN. Factors influencing the use of malaria prevention methods among women of reproductive age in peri-urban communities of Port Harcourt City, Nigeria. Niger Postgrad Med J.2016;23:6-11.
16.Calis JC, Phiri KS, Faragher EB, Brabin BJ, Bates I, Cuevas LE, et al. Severe anemia in Malawian children. Malawi Med J. 2016;28:99-107.
17.Orji ML, Onyire NB, Chapp-Jumbo A, Anyanwu OU, Eke CB. Perception and utilization of insecticide-treated mosquito net among caregivers of children in Abakaliki, Nigeria. Ann Afr Med.2018;17:172-177.
18.Morakinyo OM, Balogun FM, Fagbamigbe AF. Housing type and risk of malaria among under-five children in Nigeria: evidence from the malaria indicator survey. Malar J. 2018; 17:311.
19.National Population Commission (NPC) Nigeria and ICFInternational. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA. NPC and ICF International.
20.National Population Commission (NPC) Nigeria and ICF International. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA. NPC and ICF International.
21.Wogu MN, Nduka FO. Evaluating Malaria prevalence using clinical diagnosis compared with microscopy and rapid diagnostic tests in a Tertiary Healthcare Facility in Rivers State, Nigeria. J Trop Med. 2018; 2018:3954717.
22.Oladeinde BH, Omoregie R, Osakue EO, OnaiwuTO. Asymptomatic Malaria among Blood Donors in Benin City Nigeria. Iran J Parasitol. 2014; 9:415-422.
23.Oladeinde B, Omoregie R, Olley M, Anunibe J, Onifade A, Oladeinde O. Malaria and anemia among children in a low resource setting In Nigeria. Iran J Parasitol. 2012; 7:31-37.
24.Manning L, Laman M, Davis WA, Davis TM. Clinical features and outcome in children with severe Plasmodium falciparum malaria: a meta-analysis. PLoS One. 2014;9:e86737.
25.Edelu BO, Ndu IK, Igbokwe OO, Iloh ON. Severe falciparum malaria in children in Enugu, South East Nigeria. Niger J Clin Pract. 2018;21:1349-1355.
26.Mutombo AM, Mukuku O, Tshibanda KN, Swana EK, Mukomema E, Ngwej DT, et al. Severe malaria and death risk factors among children under 5 years at Jason Sendwe Hospital in Democratic Republic of Congo. Pan AfrMed J. 2018;29:184. [doi: 10.11604/pamj.2018.29.184.15235]
27.Kamau A, Mtanje G, Mataza C,Mwambingu G, Mturi N, Mohammed S, et al. Malaria infection, disease and mortality among children and adults on the coast of Kenya. Malar J. 2020;19:210. https://doi.org/10.1186/s12936-020-03286-6
28.Arzika AM, Maliki R, Boubacar N, Kane S, Cook CA, Lebas E, et al. Malaria Parasitemia and Nutritional Status during the Low Transmission Season in the Presence of Azithromycin Distribution among Preschool Children in Niger. Am J Trop Med Hyg. 2020;103:1315-1318.
29.Rowe AK. Analysis of deaths with an unknown cause in epidemiologic analyses of mortality burden. Trop Med Int Health. 2006;11:540-550.
30.Binka F, Akweongo P. Prevention of malaria using ITNs: potential for achieving the millennium development goals. Curr Mol Med. 2006;6:261-267.
31.Herlihy JM, D’AcremontV, Hay Burgess DC, Hamer DH. Diagnosis and Treatment of the Febrile Child. In: Black RE, Laxminarayan R, Temmerman M, Walker N, (Editors). Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016.
32.Oyibo WA, Ezeigwe N, Ntadom G, Oladosu OO, Rainwater-Loveth K, O’Meara W, et al. Multicenter Pivotal Clinical Trial of Urine Malaria Test for Rapid Diagnosis of Plasmodium falciparum Malaria. J Clin Microbiol. 2017; 55:253-263.
33.Visser T, Bruxvoort K, Maloney K, Leslie T, Barat LM, Allan R, et al. Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review. PLoS One. 2017; 12:e0173093.
34.Ndugwa RP, Ramroth H, Müller O, Jesseh M, Sié A, Kouyate B, et al. Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns. Malar J.2008; 7. https://doi.org/10.1186/1475-2875-7-15
35.Desai M, Buff AM, Khagayi S, Byass P, Amek N, van Eijk A, et al. Age-specific malaria mortality rates in the KEMRI/CDC health and demographic surveillance system in western Kenya, 2003-2010. PLoS One.2014; 9:e106197.
36.Dhingra N, Jha P, Sharma VP, Cohen AA, Jotkar RM, Rodriguez PS, et al. Adult and child malaria mortality in India: a nationally representative mortality survey. Lancet. 2010; 376:1768-1774.
37.Olofin I, McDonald CM, Ezzati M, Black RE, Fawzi WW, Caulfield LE,et al. Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013; 8:e64636.
38.Abdalla SI, Malik EM, Ali KM. The burden of malaria in Sudan: incidence, mortality and disability-adjusted life-years. Malar J.2007; 6:97. https://doi.org/10.1186/1475-2875-6-97
39.Dondorp AM, Fanello CI, Hendriksen IC, Gomes E, Seni A, ChhaganlalKD, et al. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet. 2010; 376:1647-1657.’
40.Caulfield LE, Richard SA, Black RE. Undernutrition as an underlying cause of malaria morbidity and mortality in children less than five years old. Am J Trop Med Hyg. 2004; 71:55-63.
41.Caulfield LE, de Onis M, BlössnerM, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr. 2004; 80:193-198.
42.Ferreira E, Alexandre MA, Salinas JL, de Siqueira AM, Benzecry SG, de LacerdaMVG, et al. Association between anthropometry-based nutritional status and malaria: a systematic review of observational studies. Malar J.2015; 14:346.
43.Oldenburg CE, Guerin PJ, Berthé F, Grais RF, IsanakaS. Malaria and nutritional status among children with severe acute malnutrition inNiger: A Prospective Cohort Study. Clin Infect Dis. 2018; 67:1027-1034.
2.Berhe B, Mardu F, Legese H, Negash H. Seasonal distribution and seven-year trend of malaria in NorthWestTigrai: 2012-2018, Ethiopia; 2019. Trop Dis Travel Med Vaccines.2019;5:1 -7
3.World Health Organization. World malaria report. Geneva. 2019. Assessed on January 20th,2019. https://www.who.int/publications/i/item/9789241565721.
4.Adebayo AM, Akinyemi OO, Cadmus EO. Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in southwest Nigeria. J Prev Med Hyg. 2014;55:58-64.
5.Acosta A, Obi E, Ato Selby R, Ugot I, Lynch M, Marie M, et al. Design, Implementation, and Evaluation of a School Insecticide-Treated Net Distribution Program in Cross River State, Nigeria. Glob Health Sci Pract.2018; 6:272-287.
6.Morris A, Ward A, Moonen B, Sabot O, Cohen JM. Price subsidies increase the use of private sector ACTs: evidence from a systematic review. Health Policy Plan. 2015; 30:397-405.
7.Dodo R, Zohoun A, Baglo T, Mehou J, Anani L. Emergency treatment of sickle cell diseases in the Blood Diseases Department at the Koutoukou Maga National Teaching Hospital, Cotonou, Benin. Pan Afr Med J. 2018, Jul 3;30:192.1-9
8.Korenromp E, Mahiané G, Hamilton M, Pretorius C, Cibulskis R, Lauer J, et al. Malaria intervention scale-up in Africa: effectiveness predictions for health programme planning tools, based on dynamic transmission modelling. Malar J.2016; 15:417.1-14
9.Adewemimo A, Kalter HD, Perin J, Koffi AK, Quinley J, Black RE. Direct estimates of cause-specific mortalityfractions and rates of under-five deaths in the northern and southern regions of Nigeria by verbal autopsy interview. PLoS One. 2017; 12:e0178129.
10.Korenromp E, Hamilton M, Sanders R, Mahiané G, BriëtOJ, Smith T, et al. Impact of malaria interventions on child mortality in endemic African settings: comparison and alignment between LiST and Spectrum-Malaria model. BMC Public Health. 2017; 17; 29-42
11.Murray CJ, Rosenfeld LC, Lim SS, Andrews KG, Foreman KJ, Haring D, et al. Global malaria mortality between 1980 and 2010: a systematic analysis. Lancet. 2012; 379:413-431.
12.Bhutta ZA, Sommerfeld J, Lassi ZS, Salam RA, Das JK. Global burden, distribution, and interventions for infectious diseases of poverty. Infect Dis Poverty. 2014; 3: 1-7
13.Thwing J, Eckert E, Dione DA, Tine R, Faye A, Yé Y, et al. Declines in Malaria Burden and All-Cause Child Mortality following increases in control interventions in Senegal, 2005-2010.Am J Trop Med Hyg. 2017; 97:89-98.
14.Yarhere IE, Nte AR. A Ten-year review of all cause paediatric mortality in University of Port Harcourt Teaching Hospital, Nigeria (2006 -2015). Niger J Paediatr. 2018; 45:185 -191.
15.Tobin-West CI, Kanu EN. Factors influencing the use of malaria prevention methods among women of reproductive age in peri-urban communities of Port Harcourt City, Nigeria. Niger Postgrad Med J.2016;23:6-11.
16.Calis JC, Phiri KS, Faragher EB, Brabin BJ, Bates I, Cuevas LE, et al. Severe anemia in Malawian children. Malawi Med J. 2016;28:99-107.
17.Orji ML, Onyire NB, Chapp-Jumbo A, Anyanwu OU, Eke CB. Perception and utilization of insecticide-treated mosquito net among caregivers of children in Abakaliki, Nigeria. Ann Afr Med.2018;17:172-177.
18.Morakinyo OM, Balogun FM, Fagbamigbe AF. Housing type and risk of malaria among under-five children in Nigeria: evidence from the malaria indicator survey. Malar J. 2018; 17:311.
19.National Population Commission (NPC) Nigeria and ICFInternational. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA. NPC and ICF International.
20.National Population Commission (NPC) Nigeria and ICF International. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA. NPC and ICF International.
21.Wogu MN, Nduka FO. Evaluating Malaria prevalence using clinical diagnosis compared with microscopy and rapid diagnostic tests in a Tertiary Healthcare Facility in Rivers State, Nigeria. J Trop Med. 2018; 2018:3954717.
22.Oladeinde BH, Omoregie R, Osakue EO, OnaiwuTO. Asymptomatic Malaria among Blood Donors in Benin City Nigeria. Iran J Parasitol. 2014; 9:415-422.
23.Oladeinde B, Omoregie R, Olley M, Anunibe J, Onifade A, Oladeinde O. Malaria and anemia among children in a low resource setting In Nigeria. Iran J Parasitol. 2012; 7:31-37.
24.Manning L, Laman M, Davis WA, Davis TM. Clinical features and outcome in children with severe Plasmodium falciparum malaria: a meta-analysis. PLoS One. 2014;9:e86737.
25.Edelu BO, Ndu IK, Igbokwe OO, Iloh ON. Severe falciparum malaria in children in Enugu, South East Nigeria. Niger J Clin Pract. 2018;21:1349-1355.
26.Mutombo AM, Mukuku O, Tshibanda KN, Swana EK, Mukomema E, Ngwej DT, et al. Severe malaria and death risk factors among children under 5 years at Jason Sendwe Hospital in Democratic Republic of Congo. Pan AfrMed J. 2018;29:184. [doi: 10.11604/pamj.2018.29.184.15235]
27.Kamau A, Mtanje G, Mataza C,Mwambingu G, Mturi N, Mohammed S, et al. Malaria infection, disease and mortality among children and adults on the coast of Kenya. Malar J. 2020;19:210. https://doi.org/10.1186/s12936-020-03286-6
28.Arzika AM, Maliki R, Boubacar N, Kane S, Cook CA, Lebas E, et al. Malaria Parasitemia and Nutritional Status during the Low Transmission Season in the Presence of Azithromycin Distribution among Preschool Children in Niger. Am J Trop Med Hyg. 2020;103:1315-1318.
29.Rowe AK. Analysis of deaths with an unknown cause in epidemiologic analyses of mortality burden. Trop Med Int Health. 2006;11:540-550.
30.Binka F, Akweongo P. Prevention of malaria using ITNs: potential for achieving the millennium development goals. Curr Mol Med. 2006;6:261-267.
31.Herlihy JM, D’AcremontV, Hay Burgess DC, Hamer DH. Diagnosis and Treatment of the Febrile Child. In: Black RE, Laxminarayan R, Temmerman M, Walker N, (Editors). Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016.
32.Oyibo WA, Ezeigwe N, Ntadom G, Oladosu OO, Rainwater-Loveth K, O’Meara W, et al. Multicenter Pivotal Clinical Trial of Urine Malaria Test for Rapid Diagnosis of Plasmodium falciparum Malaria. J Clin Microbiol. 2017; 55:253-263.
33.Visser T, Bruxvoort K, Maloney K, Leslie T, Barat LM, Allan R, et al. Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review. PLoS One. 2017; 12:e0173093.
34.Ndugwa RP, Ramroth H, Müller O, Jesseh M, Sié A, Kouyate B, et al. Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns. Malar J.2008; 7. https://doi.org/10.1186/1475-2875-7-15
35.Desai M, Buff AM, Khagayi S, Byass P, Amek N, van Eijk A, et al. Age-specific malaria mortality rates in the KEMRI/CDC health and demographic surveillance system in western Kenya, 2003-2010. PLoS One.2014; 9:e106197.
36.Dhingra N, Jha P, Sharma VP, Cohen AA, Jotkar RM, Rodriguez PS, et al. Adult and child malaria mortality in India: a nationally representative mortality survey. Lancet. 2010; 376:1768-1774.
37.Olofin I, McDonald CM, Ezzati M, Black RE, Fawzi WW, Caulfield LE,et al. Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013; 8:e64636.
38.Abdalla SI, Malik EM, Ali KM. The burden of malaria in Sudan: incidence, mortality and disability-adjusted life-years. Malar J.2007; 6:97. https://doi.org/10.1186/1475-2875-6-97
39.Dondorp AM, Fanello CI, Hendriksen IC, Gomes E, Seni A, ChhaganlalKD, et al. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet. 2010; 376:1647-1657.’
40.Caulfield LE, Richard SA, Black RE. Undernutrition as an underlying cause of malaria morbidity and mortality in children less than five years old. Am J Trop Med Hyg. 2004; 71:55-63.
41.Caulfield LE, de Onis M, BlössnerM, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr. 2004; 80:193-198.
42.Ferreira E, Alexandre MA, Salinas JL, de Siqueira AM, Benzecry SG, de LacerdaMVG, et al. Association between anthropometry-based nutritional status and malaria: a systematic review of observational studies. Malar J.2015; 14:346.
43.Oldenburg CE, Guerin PJ, Berthé F, Grais RF, IsanakaS. Malaria and nutritional status among children with severe acute malnutrition inNiger: A Prospective Cohort Study. Clin Infect Dis. 2018; 67:1027-1034.
Article Sidebar
Published
May 11, 2023
Article Details
How to Cite
Yahere, I. E., & Nte, A. R. (2023). A Study of Childhood Malaria trends at the University of Port Harcourt Teaching Hospital: 2006 – 2018. Nigerian Medical Journal, 64(2), 272–280. https://doi.org/10.60787/NMJ-64-2-212
Section
Original Articles
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.