Clinical Epidemiology and Geospatial Distribution of Cases of Severe Malaria in Children at a Tertiary Care Health Facility in Southwest Nigeria

Abstract

A bstract Background: Malaria has most significant epidemiologic and socio-economic impact in Sub-Saharan Africa. Nigeria contributes the largest percentage of malaria cases globally. Identification of populations at the highest risk will enable appropriate planning and implementation of preventive and control measures. Objectives: We aimed to describe the pattern of severe malaria, identify factors that determine admission outcomes, and to describe the geospatial distribution of cases in children at the University College Hospital, Ibadan, Oyo state, Southwest Nigeria. Materials and Methods: This was a cross-sectional study involving pediatric patients with severe malaria. The geographic information system was used to describe their geospatial distribution. Results: There were a total of 165 participants, which comprised 95 males (57.6%) and 70 females (42.4%) giving a male (M) to (F) ratio M:F = 1.4:1.0 The majority, 92/165 (55.8%), were less than 60 months old. The median age was 49 months (range: 8–172 months). The ratio of the under-fives to the older children was 1.3:1.0. The predominant ethnic group, [144/165 (87.3%)] was the Yoruba tribe, and the largest number of patients [32/165 (19.4%)] were from Ibadan North Local Government Area. The most common presentations were prostration [116/165 (70.3%)] and anemia [60/165 (36.4%)]. The geospatial technology revealed that domicile within 300 m of a water body and increased night-time light were significant risk factors for severe malaria ( P < 0.05). In all, 153 (92.7%) were discharged without sequelae, while 7 (4.2%) patients died. Conclusion: Although the burden of severe malaria is still borne largely by those under 5 years of age, the older children are becoming increasingly susceptible. Domicile close to water bodies, and increased night-time light increase the risk of severe malaria, suggesting that interventions to control malaria should focus on these populations.