A report on incidence of COVID-19 among febrile patients attending a malaria clinic

Abstract

Context: Screening for malaria and coronavirus disease (COVID-19) in all patients with acute febrile illness is necessary in malaria-endemic areas to reduce malaria-related mortality and to prevent the transmission of COVID-19 by isolation. Aims: A pilot study was undertaken to determine the incidence of SARS-CoV-2 infection among febrile patients attending a malaria clinic. Subjects and Methods: All patients were tested for malaria parasite by examining thick and thin blood smears as well as by rapid malaria antigen tests. COVID-19 was detected by rapid antigen test and reverse transcriptase–polymerase chain reaction in patients agreeing to undergo the test. Results: Out of 262 patients examined, 66 (25.19%) were positive for Plasmodium vivax , 45 (17.17%) for Plasmodium falciparum (Pf) with a slide positivity rate of 42.40%, and Pf% of 40.50%. Only 29 patients consented for COVID-19 testing along with malaria; of them, 3 (10.34%) were positive for COVID-19 alone and 2 (6.89%) were positive for both COVID-19 and P. vivax with an incidence of 17.24%. A maximum number of patients (196) did not examine for COVID-19 as they did not agree to do the test. Conclusion: Diagnosis of COVID-19 among three patients (10.34%) is significant both in terms of identification of cases and to isolate them for preventing transmission in the community. Detection of COVID-19 along with malaria is equally important for their proper management.

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

“…14 Moreover, the parasitaemia load was also higher in participants with a co-infection, although it remained below the level described in the 12 cases series described in the literature. 15,16 The low rate of co-infection, the fact that children and teenagers are less prone to severe COVID-19 symptoms, and that none of the screened patients had severe malaria, could also explain this observation. In addition, the species P. malariae was detected in two out of the three children with co-infection.…”

Co-Infection with Plasmodium vivax and COVID-19 in Thailand

“…Additionally, initially during the pandemic, COVID-19 testing may not have been widely available, or patients may have been hesitant. Guha et al found that, when asked permission to undergo testing for SARS-CoV-2, 75% of malaria patients declined [ 31 ]. The authors also reported a decrease in malaria clinic attendance during the pandemic.…”

Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020–2021

“…Most AFI surveillance participants described in this study were from a care-seeking population with acute symptomatic illness, which potentially yielded a higher proportion of SARS-CoV-2–positive samples. Hospitalized patients likely had more serious symptoms and a higher probability of SARS-CoV-2 infection than patients in outpatient clinics ( 16 , 17 ). Other factors, such as the level of community transmission and access to care, can also influence the percent positivity.…”

“…CDC recommended maintaining the same selection criteria for patients that were used before surveillance integration, which enabled countries to incorporate AFI surveillance systems with minimal disruption. AFI surveillance could be vital for monitoring COVID-19, which can cause fever without localizing symptoms and evade influenza-like illness surveillance if no respiratory symptoms are present ( 13 – 17 ). We describe how AFI surveillance systems were leveraged to detect and characterize SARS-CoV-2 infections using preliminary data from 5 low- to middle-income countries that incorporated SARS-CoV-2 detection into their AFI surveillance programs.…”