Journal
ACTA TROPICA
Volume 113, Issue 2, Pages 155-161Publisher
ELSEVIER
DOI: 10.1016/j.actatropica.2009.10.011
Keywords
Malaria; Anaemia; Children; Nigeria
Categories
Funding
- UNDP/World Bank/WHO
- WHO/TDR
- Pfizer Global Pharmaceuticals
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The factors contributing to anaemia in falciparum malaria were characterized in 1261 prospectively studied children in an endemic area of southwestern Nigeria. Of these, 487 (39%) presented with anaemia (haematocrit <30%). The following were found to be independent risk factors for anaemia at presentation: age <5 years, history of illness >3 days before presentation, presence of fever, a palpable liver, >parasitaemia 10,000/mu l blood, and gametocytaemia. The mean maximum fractional fall in haematocrit (FFH) after treatment was 13.8% (95% confidence interval [CI] 13-14.6) of the baseline value. This occurred 3 days after treatment began and correlated positively with enrolment haematocrit. In children whose haematocrit was >30% at enrolment, the following were found to be independent risk factors associated with subsequent development of anaemia during follow-up: age <5 years and parasitaemia >= 100,000 parasites/mu l. Haematological recovery was usually complete by 4-5 weeks, but was slower in children who were anaemic at enrolment and in those with recrudescence of their infections. Half of the children with recrudescence were still anaemic at 4 weeks. These findings have implications for the control of the burden of malarial anaemia in children in sub-Saharan African countries. (C) 2009 Elsevier B.V. All rights reserved.
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