Prevalence of malaria parasitaemia and associated factors in febrile under-5 children seen in Primary Health Care Centres in Jos, North Central Nigeria.

OBJECTIVE: This study was carried out to determine the prevalence of malaria in febrile under-5 children attending Primary Health Care Centres in relation to some demographic factors, duration of symptoms, previous antimalarial intake, presence of pyrexia, exclusive breast-feeding, mid upper arm circumference and body temperature.
METHODS: Giemsa-stained thick and thin blood films prepared from blood specimens of 260 febrile under-5 children selected randomly from 5 Primary Health Care Centres in Jos, North Central Nigeria were examined microscopically for malaria parasite.
RESULTS: A prevalence of 56.9% was recorded in this study, and only Plasmodium falciparum was encountered. Educational status of their mothers is high as only 3.8% are illiterates. Duration of illness before the visit to the centres lasted from 1 day (12.3%) to 4 days representing 39.2%. Fever, malaise, vomiting and diarrhoea are the clinical symptoms found in the patients. Majority of the patients were infants (0-12 months) representing 53.1% of the screened population and had a malaria prevalence of 52.2%. The other age groups; 13-24, 25-36, 37-48 and 49-60 months recorded 57.1%, 63.6%, 81.8% and 75% respectively (P<0.05). The males recorded a prevalence of 57.9% as against 55.9% in female (P>0.05). Prevalence in relation to duration of symptoms was 64.9% for 3 days, while the least prevalence of 42.9% was for the 2 days' duration (P>0.05). Patients with no previous antimalarial intake had a prevalence of 56.8% while those with previous antimalarial intake recorded 57% (P>0.05). Patients who had pyrexia at the time of presentation had a prevalence of 56.3% as against 57.5% in those without pyrexia (P>0.05). Patients on exclusive breast feeding had 58.3% as against 42.6% in those not on exclusive breast feeding (P<0.05). Only 16 (6.2%) of the patients had a MUAC of 12 cm and recorded the highest prevalence of 87.5%, 137 (52.7%) with a MUAC of 13-15 cm recorded 72.3%, while 107 (41.2%) with a MUAC of >15 cm had a malaria parasitaemia prevalence of 32.7% (P<0.05). Patients with body temperatures of 370 degrees C recorded the highest prevalence of 60.4%, while those with 37.1 degrees C-38 degrees C, 38.1 degrees C-39 degrees C and 39.1 degrees C-40 degrees C recorded prevalences of 60.2%, 55.6% and 23.1% respectively.
CONCLUSION: The presence of a high prevalence of malaria parasitaemia in very vulnerable under-5 children in an urban centre calls for an urgent and serious implementation of various control measures against malaria; so as to reduce the sequelae and complications associated with this infection. The cause of fever in the absence of identifiable malaria parasite suggests that other infectious agents might be responsible for the pyrexia.