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. 2007 Jul 27:6:96.
doi: 10.1186/1475-2875-6-96.

Severe falciparum malaria in young children of the Kassena-Nankana district of northern Ghana

Abraham R Oduro  1 , Kwadwo A Koram, William Rogers, Frank Atuguba, Patrick Ansah, Thomas Anyorigiya, Akosua Ansah, Francis Anto, Nathan Mensah, Abraham Hodgson, Francis Nkrumah
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Severe falciparum malaria in young children of the Kassena-Nankana district of northern Ghana

Abraham R Oduro et al. Malar J. .

Abstract

Study design: Severe falciparum malaria in children was studied as part of the characterization of the Kassena-Nankana District Ghana for future malaria vaccine trials. Children aged 6-59 months with diagnosis suggestive of acute disease were characterized using the standard WHO definition for severe malaria.

Results: Of the total children screened, 45.2% (868/1921) satisfied the criteria for severe malaria. Estimated incidence of severe malaria was 3.4% (range: 0.4-8.3%) cases per year. The disease incidence was seasonal: 560 cases per year, of which 70.4% occurred during the wet season (June-October). The main manifestations were severe anaemia (36.5%); prolonged or multiple convulsions (21.6%); respiratory distress (24.4%) and cerebral malaria (5.4%). Others were hyperpyrexia (11.1%); hyperparasitaemia (18.5%); hyperlactaemia (33.4%); and hypoglycaemia (3.2%). The frequency of severe anaemia was 39.8% in children of six to 24 months of age and 25.9% in children of 25-60 months of age. More children (8.7%) in the 25-60 months age group had cerebral malaria compared with 4.4% in the 6-24 months age group. The overall case fatality ratio was 3.5%. Cerebral malaria and hyperlactataemia were the significant risk factors associated with death. Severe anaemia, though a major presentation, was not significantly associated with risk of death.

Conclusion: Severe malaria is a frequent and seasonal childhood disease in northern Ghana and maybe an adequate endpoint for future malaria vaccine trials.

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Figures

Figure 1
Figure 1
Age-specific distribution of severe malaria and anaemia in the northern Ghana. Children aged 6–59 months with severe malaria by WHO criteria (white) and severe anaemia (black).
Figure 2
Figure 2
Venn diagram of proportions, overlap and mortality of severe malaria major clinical subgroups. Total number of major clinical subgroups in parenthesis and, mortality is given as percentage.
Figure 3
Figure 3
Seasonal prevalence of severe malaria and anaemia in the Kassena-Nankana district of Ghana. WHO criteria of severe malaria (white) and severe anaemia (black) by month of the year.
See this image and copyright information in PMC

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