PREVALENCE OF MALARIA PARASITAEMIA AMONGST FEBRILE NEONATES ADMITTED INTO THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL ENUGU, SOUTH EAST NIGERIA

Abstract

Malaria parasitaemia is the commonest cause of fever in Nigeria. Fever on its
own is the basis for malaria suspicion, investigation and treatment. However,
prevalence of malaria parasitaemia amongst febrile neonates, a vulnerable
group, has not been extensively investigated or reported in literature.
Furthermore the prevalence of neonatal malaria varies widely over different
geographical areas, thus there is need for more prevalence studies in different
areas. These inform the need to determine the prevalence of malaria
parasitaemia in febrile neonates in our centre.
This work sought to determine the prevalence of malaria parasitaemia in febrile
neonates admitted into UNTH Enugu. It also compared the prevalence of
congenital and acquired malaria in febrile neonates. Finally it compared the
prevalence of malaria parasitaemia in febrile neonates (within one week of age)
whose mothers used intermittent preventive treatment of malaria in pregnancy
with sulphodoxine pyrimethamine (IPTp-SP) and those whose mothers did not.
A total of 133 febrile neonates admitted into the neonatal ward of UNTH were
consecutively recruited for this study over a seven month period from June to
December 2013 – encompassing both rainy and dry season. Data was collected
by, first interviewing mothers/caregivers to ascertain characteristics of the
study population such as age, sex, maturity, social class of parents, place of
abode of mothers and also determine the use of IPTp-SP. Each neonate was
then tested twice for malaria parasitaemia using microscopy. Patients were also
screened for sepsis using blood culture, urine culture and cerebrospinal fluid
culture. Data was collated and analysed using statistical package for social
sciences (SPSS) version 20. Significance was set at P value less than 0.05 and
associations between categorical variables were tested using chi square,
Fisher’s exact significance and logistic regression as appropriate. Results were
presented using a combination of prose, tables and pie charts.
Results show that prevalence of malaria parasitaemia amongst febrile neonates
is high (45.11%) and that demographic factors analysed (sex, maternal place of
abode and socioeconomic status of parents) are not significantly associated
with malaria parasitaemia in febrile neonates. There is no statistically
significant difference in the prevalence of congenital and acquired malaria in
febrile neonates. However, febrile term neonates were noted to have a higher
chance of congenital malaria than febrile preterm neonates (O.R 2.6 and P
value <0.05) while there is no such difference for acquired malaria. The
prevalence of malaria parasitaemia amongst febrile neonates whose mothers
used different combinations of IPTp-SP does not significantly differ from those
whose mothers did not use IPTp-SP.
From the study it can thus be concluded that prevalence of malaria
parasitaemia in febrile neonates in our environment is high. It can also be
concluded that congenital and acquired malaria are equally prevalent amongst
febrile neonates and that IPTp-SP has not shown to be capable of preventing
symptomatic congenital malaria in this centre.