Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct 27:10:320.
doi: 10.1186/1475-2875-10-320.

Decreasing incidence of severe malaria and community-acquired bacteraemia among hospitalized children in Muheza, north-eastern Tanzania, 2006-2010

George Mtove  1 , Ben Amos, Behzad Nadjm, Ilse C E Hendriksen, Arjen M Dondorp, Abraham Mwambuli, Deok Ryun Kim, R Leon Ochiai, John D Clemens, Lorenz von Seidlein, Hugh Reyburn, Jacqueline Deen
Affiliations

Decreasing incidence of severe malaria and community-acquired bacteraemia among hospitalized children in Muheza, north-eastern Tanzania, 2006-2010

George Mtove et al. Malar J. .

Abstract

Background: The annual incidence and temporal trend of severe malaria and community-acquired bacteraemia during a four-year period in Muheza, Tanzania was assessed.

Methods: Data on severely ill febrile children aged 2 months to 14 years from three prospective studies conducted at Muheza District Hospital from 2006 to 2010 was pooled and analysed. On admission, each enrolled child had a thin and thick blood film and at least one rapid diagnostic test for falciparum malaria, as well as a blood culture. The annual incidence of bacteraemia and severe malaria among children coming from Muheza was calculated and their temporal trend was assessed.

Results: Overall, 1, 898 severe falciparum malaria and 684 bacteraemia cases were included. Of these, 1, 356 (71%) and 482 (71%), respectively, were from the referral population of Muheza. The incidence of falciparum malaria and all-cause bacteraemia in Muheza decreased five-fold and three-fold, respectively, from the first to the fourth year of surveillance (p < 0.0001). During this period, the median ages of children from Muheza admitted with severe malaria increased from 1.7 to 2.5 years (p < 0.0001). The reduction in all-cause bacteraemia was mainly driven by the 11-fold decline in the incidence of non-typhoidal salmonellosis. The annual incidences of Haemophilus influenzae and pneumococcal invasive bacterial infections decreased as well but were much fewer in number.

Conclusions: These results add to the growing evidence of the decline in malaria associated with a decrease in non-typhoidal salmonellosis and possibly other bacteraemias. Malarial prevention and control strategies may provide a greater benefit than the mere reduction of malaria alone.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Location of Tanga region in Tanzania, East Africa (Modified from: Wikipedia, http://en.wikipedia.org/wiki/Tanga_Region, accessed 15 August 2011).
Figure 2
Figure 2
Assembly of data.
Figure 3
Figure 3
Annual incidence (per 100, 000 children under 15 years of age) of severe falciparum malaria and bacteremia in Muheza*.
Figure 4
Figure 4
Annual number of deliveries at Teule hospital.
See this image and copyright information in PMC

References

    1. Reddy EA, Shaw AV, Crump JA. Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10:417–432. doi: 10.1016/S1473-3099(10)70072-4. - DOI - PMC - PubMed
    1. Alonso PL, Lindsay SW, Armstrong JR, Conteh M, Hill AG, David PH, Fegan G, de Francisco A, Hall AJ, Shenton FC. The effect of insecticide-treated bed nets on mortality of Gambian children. Lancet. 1991;337:1499–1502. doi: 10.1016/0140-6736(91)93194-E. - DOI - PubMed
    1. Bejon P, Lusingu J, Olotu A, Leach A, Lievens M, Vekemans J, Mshamu S, Lang T, Gould J, Dubois MC, Demoitié MA, Stallaert JF, Vansadia P, Carter T, Njuguna P, Awuondo KO, Malabeja A, Abdul O, Gesase S, Mturi N, Drakeley CJ, Savarese B, Villafana T, Ballou WR, Cohen J, Riley EM, Lemnge MM, Marsh K, von Seidlein L. Efficacy of RTS, S/AS01E vaccine against malaria in children 5 to 17 months of age. N Engl J Med. 2008;359:2521–2532. doi: 10.1056/NEJMoa0807381. - DOI - PMC - PubMed
    1. Lusingu J, Olotu A, Leach A, Lievens M, Vekemans J, Olivier A, Benns S, Olomi R, Msham S, Lang T, Gould J, Hallez K, Guerra Y, Njuguna P, Awuondo KO, Malabeja A, Abdul O, Gesase S, Dekker D, Malle L, Ismael S, Mturi N, Drakeley CJ, Savarese B, Villafana T, Ballou WR, Cohen J, Riley EM, Lemnge MM, Marsh K, Bejon P, von Seidlein L. Safety of the malaria vaccine candidate, RTS, S/AS01E in 5 to 17 month old Kenyan and Tanzanian Children. PLoS One. 2010;5:e14090. doi: 10.1371/journal.pone.0014090. - DOI - PMC - PubMed
    1. Kleinschmidt I, Schwabe C, Benavente L, Torrez M, Ridl FC, Segura JL, Ehmer P, Nchama GN. Marked increase in child survival after four years of intensive malaria control. Am J Trop Med Hyg. 2009;80:882–888. - PMC - PubMed

Publication types