Prevalence and factors associated with malaria parasitaemia in severely malnourished children admitted to Mulago Hospital

Abstract

Introduction: Malnutrition remains one of the most common causes of morbidity and mortality among children worldwide, and is a global challenge facing the world’s poor. In Uganda, severe malnutrition is among the leading causes of childhood morbidity and mortality. Children under five years are most vulnerable to morbidity and mortality from malaria. In sub-Saharan Africa at least 20% of childhood deaths are attributed to malaria. About 90% of all malaria deaths in the world today occur in Africa south of the Sahara. The relationship between malaria and malnutrition is controversial. Malnutrition and malaria are common in sub-Saharan Africa, and understanding the relationship between malnutrition and malaria is of great importance. Few studies have examined the association of malaria with malnutrition in areas with intense perennial malaria infection. Objective: To determine the prevalence and factors associated with malaria parasitaemia in severely malnourished children admitted to Mulago Hospital. Design: Descriptive cross sectional study. Methods: One hundred and fifty severely malnourished children aged 6-60 months and whose caretakers consented was consecutively enrolled into the study. Sociodemographic characteristics, clinical history, examination and laboratory findings were recorded. Malaria parasites were detected by microscopy. Results: The prevalence of malaria parasitaemia among the severely malnourished children was 16%. Factors found to be independently associated with malaria parasitaemia in the severely malnourished children included: the number of people living in a household and presence of stagnant water bodies around the homestead. The birth order, level of education of the caretaker, presence of thickets around the homestead, use of iron sheet roofs, ITN use, use of mosquito coils, and HIV status were not independently associated with malaria parasitaemia. Conclusion and recommendations: The prevalence of malaria parasitaemia is 16%. Malaria testing and treatment should be included in the protocol guidelines of management of severe malnutrition. Malaria must be suspected in those with low haemoglobin levels and living in households with close proximity of stagnant water. Reducing breeding grounds of mosquitoes or aquatic habitats of larvae is one of the ways malaria can be tackled.