Clinical manifestations and immune response to MSP 1(19) in severe paediatric malaria in Adeoyo state maternity hospital, Ibadan.

A 10-week cross-sectional study was carried out at the Adeoyo State Maternity Hospital (Beere, Ibadan), Southwestern Nigeria in order to determine (a) the prevalence of severe malaria, (b) identify the predominant clinical presentations that characterise the disease in children below 5 years and the pattern of antibody responses to MSP 19 elicited in severe malaria complications. Three thousand, one hundred and thirty-one cases reported to the Out Patients' Department; of these, 372 (11.8%) subjects were recruited on the basis of doctors' diagnosis of severe malaria, malaria and other complications. Six per cent (188/3131) ofthe patients were admitted. Serum samples for 320 ofthe 372 subjects were analysed for antibodies specific to MSP 1(19) by ELISA. The highest antibody responses occurred in the age group 2-5 years. Parasite prevalence was 77.9% (290 of 372 subjects) and parasite density ranged from 80 to >100000 parasites/microL blood. Fever (an average temperature of 38.6 +/- 0.4 degrees C and peak at 41 degrees C) and severe malaria were the major clinical manifestations of malaria amongst the study population. Severe malaria was found to be associated with other features such as cough, vomiting and diarrhoea.