Project Materials

EFFECTS OF MANAGEMENTS OF MALARIA ON HAEMATOLOGICAL, BIOCHEMICAL AND NUTRITIONAL CHANGES IN CHILDREN

ABSTRACT

This study looked at how home (community) and hospital-based paediatric malaria management affected the prevalence, haematology, biochemistry, and nutritional markers of malaria parasite-infected children in Anambra State, Nigeria. It also assessed mothers’ and carers’ knowledge, attitudes, and opinions of childhood malaria, as well as their home management strategies. The study included 248 children aged 0 to 14.9 years, as well as 653 randomly selected households. Blood samples were taken from 134 male children (39 from communities and 95 from hospitals) and 114 girls (43 from communities and 71 from hospitals). These children were treated for malaria either in hospitals or at home by their mothers/caregivers. Standard methods were used to determine serum levels of sodium ion (mmol/l), total protein (g/dl), bilirubin (mg/dl), alkaline phosphatase (ALP iu/l), serum glutamate oxaloacetate transaminase (SGOT u/l), serum glutamate pyruvate transaminase (SGPT u/l), packed cell volume (PCV%), haemoglobin (Hb mg/dl), and white blood cell (WBC mcl). Anthropometric data, including age, height, weight, and mid-upper arm circumference (MUAC), were gathered using a standard scale, tape, and MUAC UNICEF insertion tape. To test for significant differences between the variables, Chi-square, Fisher’s least significant difference, t-test, analysis of variance, multiple regression, and Epi Info were used. The significance level for each determination was set at p<0.05. Malaria prevalence in the community was 46.3%, compared to 94.0% in hospitals. Malaria parasite infection was not associated with age or gender (p>0.05). The community prevalence of malaria did not differ significantly (p>0.05), but monthly and seasonal prevalences did (p<0.05). Female children infected with malaria had significantly higher mean PCV than male children in both communities (31.73 ± 458 to 28.25 ± 3.75) and hospitals (31.12 ± 11.78 to 28.27 ± 5.56) (p<0.05). Female infected children had considerably higher WBC counts than boys (p<0.05). Males had considerably greater (p<0.05) SGOT in hospital samples compared to residences. In malaria infection, serum WBC levels were dependent on gametocyte count. In both communities and hospitals investigated, gametocyte counts of 1-10 and 11-100 showed substantial (p<0.05) differences in WBC count. Children aged 0–4.9 years had significantly higher (p<0.05) mean blood levels of birilubin (0.55 ± 0.25 to.35 ± 0.14). The survey found that children aged 10 – 14.9 had considerably higher mean Hb levels (10.30 ± 0.29 to 10.90 ± 0.26) compared to other age groups (p<0.05). Malaria-infected children aged 5–9.9 years had significantly lower PCV and Hb levels (p<0.05) than the control group. Changes in serum sodium ion levels (Na+, SGOT, ALP, and SGPT) may not be related to malaria infection. The prevalence of malnutrition (weight-for-height Z-scores) among malaria uninfected in the community and hospital surveys was 26.7% (14.2 – 44% 95% confidence interval) and 9.2% (4.7 – 17.1 95% confidence interval), respectively, while the prevalence among malaria parasite-infected children was 21.4% and 7.4% in the community and hospital, respectively.