M Khogali1, R Zachariah2, A Keiluhu1, K Van den Brande1, K Tayler-Smith2, L Ayada2, D Jima3, S G Hinderaker4, A D Harries5. 1. Médecins Sans Frontières, Addis Ababa, Ethiopia. 2. Medical Department (Operational Research Unit/Operations), Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg. 3. Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia. 4. Centre for International Health, University of Bergen, Bergen, Norway. 5. International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
Abstract
SETTING: Forty-eight nutritional rehabilitation centres in southern Ethiopia. OBJECTIVE: To determine 1) the frequency of temperature recording under programme conditions, 2) the proportion of malnourished children with and without fever who had falciparum malaria and 3) the association between malaria and grade of malnutrition. DESIGN: This was a retrospective analysis of routine programme data. RESULTS: Of 19 200 malnourished children, 16 716 (mean age 4.4 years, 7412 males) underwent a rapid malaria diagnostic test (Paracheck Pf (®)). Malnutrition was graded as severe (38%), moderate (35%) and mild (27%). Temperature was not recorded in 15 248 (91%) children. Malaria was diagnosed in 57 (28%) children with fever (n = 206) and 122 (10%) children with no fever (n = 1262). The prevalence of falciparum malaria was 9%. Malaria prevalence was significantly associated with grade of malnutrition: Paracheck Pf was positive in respectively 5%, 8% and 10% of children with mild, moderate and severe malnutrition (χ(2) for trend 78, P < 0.001). CONCLUSIONS: This study shows the value of routine malaria screening in malnourished children, especially those with more severe grades of malnutrition, irrespective of fever. Operational shortcomings are highlighted and ways forward to address these problems are discussed.
SETTING: Forty-eight nutritional rehabilitation centres in southern Ethiopia. OBJECTIVE: To determine 1) the frequency of temperature recording under programme conditions, 2) the proportion of malnourished children with and without fever who had falciparum malaria and 3) the association between malaria and grade of malnutrition. DESIGN: This was a retrospective analysis of routine programme data. RESULTS: Of 19 200 malnourished children, 16 716 (mean age 4.4 years, 7412 males) underwent a rapid malaria diagnostic test (Paracheck Pf (®)). Malnutrition was graded as severe (38%), moderate (35%) and mild (27%). Temperature was not recorded in 15 248 (91%) children. Malaria was diagnosed in 57 (28%) children with fever (n = 206) and 122 (10%) children with no fever (n = 1262). The prevalence of falciparum malaria was 9%. Malaria prevalence was significantly associated with grade of malnutrition: Paracheck Pf was positive in respectively 5%, 8% and 10% of children with mild, moderate and severe malnutrition (χ(2) for trend 78, P < 0.001). CONCLUSIONS: This study shows the value of routine malaria screening in malnourished children, especially those with more severe grades of malnutrition, irrespective of fever. Operational shortcomings are highlighted and ways forward to address these problems are discussed.
Entities:
Keywords:
Ethiopia; malaria; malnutrition; rapid diagnostic test; temperature
Authors: Peter Maes; Anthony D Harries; Rafael Van den Bergh; Abdisalan Noor; Robert W Snow; Katherine Tayler-Smith; Sven Gudmund Hinderaker; Rony Zachariah; Richard Allan Journal: PLoS One Date: 2014-04-03 Impact factor: 3.240