Estimating the Fraction of Severe Malaria among Malaria-Positive Children: Analysis of Household Surveys in 19 Malaria-Endemic Countries in Africa

Taylor, Cameron; Namasté, Sorrel; Lowell, Joanna; Useem, Johanna; Yé, Yazoumé

doi:10.4269/ajtmh.20-1351

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…In this study, 22.03% (95% CI 12.25%, 31.80%) under-five children were infected with malaria. The finding is comparable to the pooled estimate in sub-Saharan countries (18.8%) [ 46 ], (21%) [ 47 ], and (26%) [ 48 ], the national malaria survey in Gambella (21%) [ 49 ], a study in Uganda (19.04%) [ 50 ], the national malaria survey in Ghana (21%) [ 51 ], and the national malaria survey in Nigeria (27%) [ 52 ]. These findings pointed out that malaria is still a concern for children under 5 years old.…”

Section: Discussionsupporting

confidence: 74%

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis

Biset

Tadess

Tegegne

et al. 2022

Malar J

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Background Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria. Methods The protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I2 test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger’s and Begg’s statistical tests. Results Twelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria. Conclusion More than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission.

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Section: Discussionsupporting

confidence: 74%

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis

Biset

Tadess

Tegegne

et al. 2022

Malar J

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“…This study showed that the majority of the children admitted were under 5 years of age and this was consistent for all the years under study, including 2020. This is typical of the malaria morbidity among children in malaria endemic areas, with areas of high malaria transmission (like the study area) affecting younger children and low transmission areas affecting older children [36][37][38]. Also, there is corresponding high mortality among children in areas of high malaria transmission as seen in this study [37,38].…”

Section: Plos Global Public Healthmentioning

confidence: 54%

“…This is typical of the malaria morbidity among children in malaria endemic areas, with areas of high malaria transmission (like the study area) affecting younger children and low transmission areas affecting older children [36][37][38]. Also, there is corresponding high mortality among children in areas of high malaria transmission as seen in this study [37,38]. This finding was again consistent for each year under study except 2020, where death was recorded more for older children, although this finding was not significant.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Evaluating the impact of COVID-19 pandemic on complicated malaria admissions and outcomes in the paediatric Ho Teaching Hospital of the Volta Region of Ghana

Orish

Akake

Lokpo

et al. 2022

PLOS Glob Public Health

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Since Ghana recorded its first cases of COVID-19 in early March 2020, healthcare delivery in the country has been hugely affected by the pandemic. Malaria continues to be an important public health problem in terms of morbidity and mortality among children, and it is responsible for significant hospital visits and admission. It is likely that, as with other illnesses, the COVID-19 pandemic may have impacted health seeking behaviour, hospital visits, and admissions of malaria among the paediatric population in Ghana. The aim of this study was to evaluate the impact of COVID-19 pandemic on the admissions and outcome of complicated malaria in the Ho Teaching Hospital of the Volta Region of Ghana. The medical records of children admitted for complicated malaria (cerebral and severe malaria) from 2016 to 2020, were obtained from the admission records of the children. Both demographics and clinical details were collected, and data was analysed using SPSS version 25 statistical software. The yearly differences in the trend and proportions of complicated malaria admissions were performed using rate comparison analysis and Pearson chi-square was used to assess the association between the various demographic factors and yearly admission rates. Clopper-Pearson test statistic was employed to determine the 95% confidence intervals of outcome variables of interest. The year 2020 had the lowest admission for complicated malaria (149, 11.5%; 95% CI: 9.7-13.5) but proportionally had, more cases of cerebral malaria (25, 16.8%; 95% CI: 10.9-24.8), and more deaths (6, 4.0%; 95% CI: 1.5-8.8), compared to the years under review. Children admitted in 2020 had the shortest mean stay on admission (4.34 ±2.48, p<0.001). More studies are needed to further elucidate the impact of the COVID-19 pandemic on the health of children in malaria endemic areas.

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“…[5][6][7] In a survey done between 2015 and 2018 in 19 malaria endemic countries of Africa, 4.5% of all malaria-infected children reported at least one symptom of severe malaria. 8 The most common presentations of severe malaria reported vary depending on the study site: severe malarial anemia (SMA), multiple convulsions, cerebral malaria, also, hypoglycaemia haemoglobinuria and acute renal failure were documented. 5,7,[9][10][11][12] Mortality due to severe malaria showed a relatively steady decline with reported case fatality rate of 11.2% in 2004 in Ghana, 9.0% in 2005 in Gabon and 6.9% in 2007 in Ibadan Nigeria, possibly attributable to the series of actively ongoing global interventions against malaria.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of impact of COVID-19 pandemic on the burden and pattern of severe malaria in Nigerian children

Bamidele¹,

Ezeonwu²,

Ajaegbu³

et al. 2023

Int J Community Med Public Health

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Background: Malaria is an infectious disease caused by the protozoan Plasmodium, accounting for 36% of under-five mortality. About 4.5% of all malaria-infected children reported at least one symptom of severe malaria, with worsening outcome. COVID-19 and malaria shared similar clinical presentation in children this similarity may lead to delay in initiation of treatment for malaria, with progression from uncomplicated to severe forms and consequently high mortality. Thus, we set out to study the extent COVID-19 impacted on the burden and pattern of severe malaria. Methods: It was a retrospective study of all the children admitted into the children’s emergency room severe malaria, from March 2018 to February 2022. The data collected included the total number of admissions within the period, the month and year of admission, age, gender, the component of severe malaria that was the final diagnosis and outcome of management. Data were analysed using NCSS 9 statistical software. Results: There were 4761 admissions within the study period: males were 54.7%, subjects 1-<60 months were 60.5% and pre COVID-19 period were 63.7%. The prevalence rates of severe malaria in CHER were 2.6%. Among those with severe malaria, the case fatality rate was 10.7%. Severe malarial anemia was the most common accounting for 49.2% and has predilection for the younger age. Cerebral malaria was predominantly diagnosed during the COVID-19 period. Conclusions: The prevalence of severe malaria was 2.6% and severe malaria anaemia was the most common mode of presentation while cerebral malaria was diagnosed more during the COVID-19 period.

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Estimating the Fraction of Severe Malaria among Malaria-Positive Children: Analysis of Household Surveys in 19 Malaria-Endemic Countries in Africa

Cited by 10 publications

References 20 publications

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis

Evaluating the impact of COVID-19 pandemic on complicated malaria admissions and outcomes in the paediatric Ho Teaching Hospital of the Volta Region of Ghana

Evaluation of impact of COVID-19 pandemic on the burden and pattern of severe malaria in Nigerian children

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