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Anti-Malarial Prescription Practices for Children with Negative Microscopy Results for Malaria Parasites Admitted at the Moi Teaching and Referral Hospital, Kenya


JM Simba
IK Marete
A Mwangi
SO Ayaya

Abstract

Background: The burden of malaria is declining globally including Kenya, however a high number of  patients continue to be treated for malaria in our set up. Adopting correct diagnosis and appropriate  treatment is cost effective, prevents resistance to anti-malarial and has been shown to save lives.
Objective: To determine the clinicians’ anti-malarial prescription practices in the management of children with negative microscopy results.
Design:A prospective observational study.
Setting: General Paediatric wards of Moi Teaching and Referral Hospital, Kenya.
Subjects:A total of 250 children, aged one month to forteen years, admitted with a negative microscopy results for malaria parasites were enrolled from December 2012 to June 2013.
Main Outcomes: Anti-malarial prescription and duration of stay in hospital.
Results: The median age of the participants was 19.5 months (IQR10, 36) with 150 (60%) being male.  Forty one (16%) of the participants had travelled to malaria endemic regions in the preceding four weeks while 30 (12%) had used anti-malarial prior to admission. Those treated with anti-malarial with negative microscopy results were 34 (13.6%). Increased sleepiness, history of headache and prior anti-malarial  use were independent clinical characteristics associated with treatment. The mean duration of hospital stay was 3.53 days for those on anti-malarial versus 3.75 days for those not treated (P =0.61). One participant died in the group not on anti-malarial.
Conclusion: There was a substantial proportion of children treated for malaria with negative microscopy results. No difference was noted in duration of hospital stay in comparison with the group not treated with anti-malarial.

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eISSN: 0012-835X