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Characteristics of febrile Children in a Malaria/HIV co-endemic region of Western Kenya
Abstract
Background: Fever is still a priority health problem in the paediatric population. The cause of fever in children in resource-limited settings is not always investigated and thus clinical characteristics are relied on to make presumptive diagnosis especially for malaria.
Objectives: To determine the demographic, clinical and haematological characteristics of febrile children in the context of their HIV and malaria parasitemia status.
Design: A cross-sectional comparative hospital based study was carried out on febrile children seeking care in the ambulatory clinics.
Setting: Webuye Sub-County Hospital in western Kenya.
Main Outcomes: Demographic and clinical characteristics for those who met the inclusion criteria. Malaria parasitemia using blood slide and haematological characteristics based on complete blood count.
Results: A total of 282 febrile HIV-infected and 332 Non-HIV-infected were recruited into the study. Prevalence of malaria parasitemia was 84% and 51.2% among HIV-infected and the non-HIV-infected febrile children respectively. Of the HIV-infected, 97% were on cotrimoxazole. The HIV-infected were significantly older than the non-infected with a median age of 59 (IQR43, 89) and 48(IQR36, 60) months respectively. Splenomegaly, hepatomegaly and anaemia were more common among the HIV-infected (p-value 0.000, 0.0001 and 0.000 respectively). However, these HIV-infected children had generally more favourable haematological parameters (haemoglobin & MCV) compared to the HIV-non- infected (p-alue≤0.0001).
Conclusion: HIV infected children with malaria parasitemia were significantly older than non-HIV infected in western Kenya. The HIV infected children however had better haematological parameters compared to the non-HIV infected. There is need to intensify other preventive measures for malaria in this community as it appears cotrimoxazole prophylaxis does not confer additional benefit to those with HIV.
Objectives: To determine the demographic, clinical and haematological characteristics of febrile children in the context of their HIV and malaria parasitemia status.
Design: A cross-sectional comparative hospital based study was carried out on febrile children seeking care in the ambulatory clinics.
Setting: Webuye Sub-County Hospital in western Kenya.
Main Outcomes: Demographic and clinical characteristics for those who met the inclusion criteria. Malaria parasitemia using blood slide and haematological characteristics based on complete blood count.
Results: A total of 282 febrile HIV-infected and 332 Non-HIV-infected were recruited into the study. Prevalence of malaria parasitemia was 84% and 51.2% among HIV-infected and the non-HIV-infected febrile children respectively. Of the HIV-infected, 97% were on cotrimoxazole. The HIV-infected were significantly older than the non-infected with a median age of 59 (IQR43, 89) and 48(IQR36, 60) months respectively. Splenomegaly, hepatomegaly and anaemia were more common among the HIV-infected (p-value 0.000, 0.0001 and 0.000 respectively). However, these HIV-infected children had generally more favourable haematological parameters (haemoglobin & MCV) compared to the HIV-non- infected (p-alue≤0.0001).
Conclusion: HIV infected children with malaria parasitemia were significantly older than non-HIV infected in western Kenya. The HIV infected children however had better haematological parameters compared to the non-HIV infected. There is need to intensify other preventive measures for malaria in this community as it appears cotrimoxazole prophylaxis does not confer additional benefit to those with HIV.
