Prevalence of malaria infection in children in Anambra state, Nigeria after change of policy from presumptive/clinical to confirmed diagnosis

Abstract

In 2011, WHO change malaria case-management policy from presumptive treatment of fevers to parasitological diagnosis and targeted treatment with artemisinin combination therapy (ACTs). Between 2010 and 2012, a series of activities were undertaken to support the implementation of the new policy. Regular monitoring of the quality of malaria case-management was carried out to inform policy makers, implementers and donors agencies on the implementation progress. This study was carried out to estimate the effects of this new WHO policy on the prevalence of malaria parasite infection in children from selected communities in Anambra State, Nigeria. This study was conducted in thirteen communities purposively selected from thirteen local government areas in Anambra State using children aged 0 – 14.90 years. Venous blood samples were collected from 82 and 166 children from the communities and hospitals, respectively for thick films blood smears for microscopy. Chi-square (χ²) and Fisher least significance difference test were used to analyse the data collected. The overall prevalence of malaria based on the community survey in Anambra State was 46.30 %, while the prevalence of malaria based on hospital survey was 94.60 %. The result of this study showed that there was no significant difference in infection rate in relation to age in both community and hospital survey. There should be proper management of childhood malaria in the homes and hospitals. This could be achieved by training and retraining of health care workers and mothers/care givers in the formal health care delivery systems to ensure quick and accurate diagnosis of malaria parasite infection of children in Anambra State, Nigeria.

Keywords: Prevalence of malaria, Children, Anambra State, Nigeria, Presumptive policy, Confirmed diagnosis, Hospital malaria vs. Community malaria