PRESUMPTIVE DIAGNOSIS OF MALARIA IN FEBRILE CHILDREN; IS IT JUSTIFIED?

Background: Malaria is deadly and a major disease burden in Africa especially among the under-5s. Due to the high death rate from malaria in endemic region, World Health Organization previous recommendation was presumptive treatment of malaria. Aim: This study aimed to evaluate if presumptive diagnosis of malaria in our region is still justified, and increase the awareness for proper evaluation for other causes of fever in febrile children. Methods: Apart of a single blinded prospective interventional study carried out between March and May 2016, at the children outpatient unit of Lagos State University Teaching Hospital, Ikeja, Nigeria. Consecutive children aged 6 months to 12 years with temperature of 37.50C and above at presentation without prior antimalaria treatment were recruited. Clinical and laboratory evaluation for malaria were done in these subjects. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Test of statistical significant was set at <0.05. Results: Eighty-eight (88) children were recruited. The mean age of studied subjects was 43±46.5 months with a median of 25 months. Male to female ratio was 1.1:1. The axillary temperature range of studied subjects ranged between 37.50C to 390C. The mean temperature of subjects was 37.8±0.370C. Out of 88 children recruited for the study, 51 (58%) had microscopic malaria test being positive. Up to 37 (42%) febrile children tested negative for malaria. Conclusion: Malaria infection in children is still high in our environment, but presumption treatment of malaria is no longer justified. There is a need to scale up provision of diagnostic tools for malaria so that overtreatment can be curtailed.