Malaria Related Deaths among Children with Manifestations of Fever Symptoms on Admission in a Secondary Health Care Institution in Western Region of Ghana – A Retrospective Study | Chapter 3 | Current Trends in Disease and Health Vol. 3

Background: Malaria is a major contributor to deaths in children especially in sub-Saharan Africa. Children less than five years of age are susceptible to malaria infection in endemic regions leading to serious complications. Malaria causes death in children either directly through Cerebral Malaria (CM) and Severe Malaria Anaemia (SMA) or indirectly through co-morbidity with pneumonia or a sequela like hypoglycaemia.

Methods: This retrospective study examined malaria-related deaths among children at Effia-Nkwanta hospital within a study period of 3 years.

Results: A total of 1,416 medical records were reviewed, out of which 223 were medical records of children with fatal outcomes. Deaths over the study period due to all causes were 15.7% (223/1416) and confirmed malaria was 13.7% (40/292). Deaths due to all causes and confirmed malaria decreased from 21.6% and 24.3% in 2010 to 11.1% and 4.4% in 2012, respectively. Anti-malarial testing was done for 152 of the children with 40 positive and 112 negative results. Seventy-one children had no malaria testing done on them, with 23.4% in 2010 40.3% in 2011 and 35.5% in 2012. Anti-malarial treatment was administered to 83% of children who tested negative and 80% of children without anti-malarial testing.

Conclusion: Deaths in the children declined from 2010 to 2012 in this study. Despite this improvement, there was poor anti-malarial testing and improper use of anti-malarial treatment. National malaria programs should ensure improvement in anti-malarial testing and strict adherence to the anti-malarial treatment protocol.

Author(s) Details

Verner N. Orish

Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana.

Adekunle O. Sanyaolu,  

AMOOF Healthcare Consulting, Canada.

Mahama Francois,

Ho Polytechnic, Ho, Volta Region, Ghana.

Bruku K. Silverius,

Takoradi Polytechnic, Sekondi-Takoradi, Sekondi, Western Region, Ghana.

Onyekachi S. Onyeabor,

Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA.

Chuku Okorie,

Essex County College, Newark, New Jersey, USA.

Nnaemeka C. Iriemenam,

Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. View Book –

Neglected Tropical Diseases (NTDs): Case Study on Gastrointestinal Parasites and Morbidity Indicators in Some Rural Villages of the South Region of Cameroon | Chapter 06 | Current Trends in Disease and Health Vol. 1

Background: Parasitic diseases in tropical regions are important cause of morbidity and mortality. Some groups of infection that sufficient attention has not been attributed to by donors and planners worldwide still exist presently. These infections include schistosomiasis, soil transmited helminthes (STHs), amibiasis etc. Intestinal parasitic infections still constitute major public health threats in many parts of Cameroon. To improve on the different control measures and their effectiveness, continuous surveys are necessary to update epidemiological data.

Aim: This study aim to evaluate the transmission level of intestinal parasitosis and morbidity indicators link to infections in inhabitants of Lolodorf Health district in south Cameroon. Informations from such studies will permit to build concrete recommendations for the National control program for these infections.

Methodology: A total of 423 participants were recruited for the study. Stool samples were collected and examined microscopically for the search of helminthes eggs and protozoan cysts using Kato Katz and concentration formol-ether techniques respectively. Anemia was evaluated by measuring heamoglobin level using the spectrophotometic technic with a hemoglobinometer URIT-12 while malnutrition was determined by taking anthropometric parameters.

Results: Out of 423 participants examined, 321 (75.9%) were infected with Ascaris lumbricoides (30.3%), Trichuris trichiura (64.5%), Hookworms (12.5%), E. histolytica/ E. dispar (9.9%) and E. coli (34.0%). Among infected individuals, 117 (36.4%) had single infections, while 204 (63.6%) had multiple infections. Multiple infections were significantly high (P= 0.0001) compared to single infections.  E. histolytica/ E. dispar infection was significantly more prevalent in females than in males (P=0.01), same as in participants of 3-5 years for Hookworms (P= 0.02), 3-5 years and 11-15 years for E. coli (P= 0.04). T. trichura infections occurred more frequently as single infection (P= 0.0001). Interactions between T. trichiura+ E. coli led to a significant increase of E. coli prevalence (P= 0.001). Significant high egg load was observed for T. trichiura (P= 0.00001) and in people between 3-5 years infected by T. trichiura (P=0.0001) and hookworms (P=0.0001). Low infection intensity was significantly more observed compared to moderate and high infection intensities (P= 0.0001) for A. lumbricoides, T. trichiura, and Hookworm. T. trichiura density increases significantly when it interacts with A. lumbricoides + Hookworms, A. lumbricoides + E. coli, Hookworms + E. coli, E. histolytica/ E. dispar + E. coli, A. lumbricoides + Hookworms + E. coli and A. lumbricoides + E. histolytica/ E. dispar + E. coli (P< 0.05).Anemia and malnutrition were the morbidity indicators evaluated. Participants were severely anemic (46.2%) with probable chronic malnutrition (36.7%). Moderate anemia was significantly more observed in infected participants (49.7%: P<0.0001), same for participants of 11-15 years for the two indicators (P<0.0001).

Conclusion: This study has demonstrated that the Ngovayang health area in the health district of Lolodorf is highly endemic for intestinal parasites with high level of anemia and malnutrition observed in individuals, constitutes an area with high risk of transmission. This implies that, the protocol of mass drug administration recommended by MINSANTE might not be adequate to reduce the endemicity level and morbidity caused by these parasites.  Also, recommendations for control measures should be done while taking into consideration the impact of morbidity indicators in infected population.

Author(s) Details

Dr. Nkengazong Lucia
Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaounde, P.O.Box 13033, Cameroon & Laboratory of Parasitology and Ecology, Faculty of Science, University of Yaounde I, P.O.Box 812, Cameroon.

Ngo Ngue Thérèse Nadyne
Faculty of Science, University of Ngaoundere, P.O.Box 454, Cameroon.

Professor Nukenine, Elias Nchiwan
Faculty of Science, University of Ngaoundere, P.O.Box 454, Cameroon.

Ngué Monique
Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaounde, P.O.Box 13033, Cameroon.

Prof. Moyou-Somo Roger
Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaounde, P.O.Box 13033, Cameroon.

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