Abstract
This study determined the trends of fever in relation to parasitaemia and established Pyrogenic threshold (PYT) for malaria in Nigerian children. Two cross-sectional surveys of malaria and fever were carried out during the dry and rainy seasons of 2007 and 2008 in children aged 6 mo −11 yr attending two Primary Health Care Centres (PHC) in Lagos, Nigeria. Structured questionnaires were used to capture data. A total of 505 children attending PHC during the rainy (n = 385) and dry (n = 116) seasons were studied. Unlike in the dry season, the parasite rate increased with age until 59 mo during the rainy season, while both fever rate (19.7–25.4% vs. 14.1–17.7%) and parasite and fever rate combined (13.4–16.7% vs. 9.2–11.2%) showed a decrease with increasing age. More febrile cases with parasitaemia occurred in children aged 23 mo and below compared to those within the 24–59 mo age bracket during the rainy season only (P < 0.05). For all the age groups combined, mean PYT of 2675 and 3000 parasite/uL in 2007 and 2008 during the rainy season and 610 parasites/uL during the dry season (both years) were found. The use of non-artemisinin based combination interventions by caregivers increased the PYT, by 0.5–8.4%. We conclude that fever has become less reliable for syndromic diagnosis of malaria in children below 5 yr in this environment, and that laboratory confirmation of the diagnosis should be mandatory in all cases.
Keywords
Plasmodium falciparum - malarial fever - pyrogenic threshold - Nigerian children
