Investigation of Malaria by Microscopy among Febrile Outpatients of a Semi‑Rural Nigerian Medical Center: What Happened to Malaria Control Programs?
DOI:
https://doi.org/10.60787/njgp.v17i1.78Keywords:
rural, Northern Nigeria, malaria prevalence, Febrile patientsAbstract
Background: Older reports estimate that malaria accounts for 60% of outpatient clinic encounters in Nigeria. However, current estimates suggest that malaria control programs have considerably reduced malaria‑related morbidity and mortality on a global scale. The extent to which these programs impacted malaria prevalence in endemic countries such as Nigeria after the Millennium‑Development Goals era may not have been fully appreciated. This study, therefore, assessed how common malaria was among febrile patients attending a semi‑rural medical center in Nigeria.
Materials and Methods: This was a cross‑sectional study involving 290 randomly selected general and pediatric outpatients (who fulfilled inclusion criteria) attending the Federal Medical Centre, Birnin Kudu in August 2016. It assessed participants’ clinical features, insecticide‑treated net usage and presence of malaria parasitemia (confirmed by microscopy).
Results: Participants’ overall mean age was 18.4 ± 16.3 years (ranging from 0.25–62.0 years); 146 (50.3%) were females; 73.4% used insecticide‑treated‑net the previous night. Their mean overall temperature was 37.7°C ± 1.1°C. Overall malaria prevalence was 65.5%; however, the incidence was highest in ≥15 years age‑group (30.3%) followed by ≤4 years age group (20.7%). Clinical features predicting malaria parasitemia were pallor (odds ratio [OR] = 5.03, 95% confidence interval [CI] = 1.96–14.42) and history of convulsion (OR = 4.06, 95% CI = 1.53–10.78). Their median parasite density was 1 ± 1.3. Clinical features poorly predicted malaria parasite density among participants.
Conclusion: The malaria prevalence in this study was worryingly high. There is a need to review or modify current malaria control programs using more comprehensive strategies if reduction in the malaria‑related morbidity and mortality in this and similar settings is desired.
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