Clinical overlap between malaria and pneumonia: can malaria rapid diagnostic test play a role?

  • Kingsley Nnanna Ukwaja Comprehensive Health Centre, Oke-Ilewo, Abeokuta, Ogun state, Nigeria
  • Olufemi B Aina Comprehensive Health Centre, Oke-Ilewo, Abeokuta, Ogun state, Nigeria
  • Ademola A Talabi Comprehensive Health Centre, Oke-Ilewo, Abeokuta, Ogun state, Nigeria
Keywords: malaria-pneumonia, overlap, rapid diagnostic tests, Nigeria

Abstract

Introduction: Malaria and pneumonia account for 40% of mortality among children under five years of age in sub-Saharan Africa. Due to lack of diagnostic facilities, their management is based on the integrated management of childhood illnesses (IMCI) strategy. Symptoms of malaria and pneumonia overlap in African children, necessitating dual IMCI classifications at health centres and treatment with both antibiotics and antimalarials. This study determined the prevalence of malaria-pneumonia symptom overlap and confirmed the diagnosis of malaria in these cases using a rapid diagnostic test.

Methodology: Consecutive consultations of 1,216 children (two months to five years old) were documented over a three-month period in a comprehensive health centre. Malaria rapid diagnostic tests were conducted only for children who had symptom overlap.

Results: Of the 1,216 children enrolled, 1,090 (90%) reported cough or fever. Among the children fulfilling the malaria case definition, 284 (30%) also met the pneumonia case definition. Twenty-three percent (284) of all children enrolled met the criteria for both malaria and pneumonia. However, only 130 (46%) of them had a positive result for malaria using a malaria rapid diagnostic test. During a malaria-pneumonia overlap, female children (chi-square 5.9, P = 0.01) and children ≥ one year (chi-square 4.8, P = 0.003) were more likely to seek care within two days of fever.

Conclusion: Dual treatment with antimalarials and antibiotics in children with malaria-pneumonia overlap may result in unnecessary over-prescription of antimalarial medications. Use of rapid diagnostic tests in their management can potentially avoid over-prescribing of malaria medications.

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Author Biographies

Kingsley Nnanna Ukwaja, Comprehensive Health Centre, Oke-Ilewo, Abeokuta, Ogun state, Nigeria
I am a research physicien working in a Comprehensive Health Centre where I provide primary care services to an underserved population. I also conduct research involving childhood pneumonia, malaria, TB case finding e.t .c in community settings.
Olufemi B Aina, Comprehensive Health Centre, Oke-Ilewo, Abeokuta, Ogun state, Nigeria
Medical Officer, Abeokuta-South Local Government Area, Ogun State, Nigeria
Ademola A Talabi, Comprehensive Health Centre, Oke-Ilewo, Abeokuta, Ogun state, Nigeria
Director, Primary Health Care and Disease Control / Principal Medical Officer of Health, Abeokuta-South Local Government Area, Ogun State, Nigeria
Published
2011-03-21
How to Cite
1.
Ukwaja KN, Aina OB, Talabi AA (2011) Clinical overlap between malaria and pneumonia: can malaria rapid diagnostic test play a role?. J Infect Dev Ctries 5:199-203. doi: 10.3855/jidc.945
Section
Original Articles