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 management of childhood malaria 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 views of childhood malaria, as well as their home management strategies. The study included 248 children aged 0 to 14.9 years old, as well as 653 randomly recruited households. Blood samples were obtained 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 infection in hospitals or at home by their mothers/caregivers. Standard methods were used to assess 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 UNICEF MUAC insertion tape. Chi-square, Fisher’s least significant difference, t-test, analysis of variance, multiple regression, and Epi Info were used to assess for significant differences between the variables. The significance level for all determinations was p<0.05. Malaria prevalence in the population was 46.3%, compared to 94.0% in the hospital. Malaria parasite infection did not differ significantly by age or gender (p>0.05). The population prevalence of malaria did not differ significantly (p>0.05), although there was a significant difference in monthly and seasonal prevalence (p<0.05). Female malaria-infected children had significantly higher mean PCV than males 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 significantly higher WBC counts (p<0.05) compared to males. Males had considerably higher (p<0.05) SGOT in the hospital than at home. Serum WBC levels in malaria infection were gametocyte count dependent. Gametocyte counts of 1-10 and 11-100 in assessed towns and hospitals showed substantial (p<0.05) differences in WBC counts. 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) compared to other age groups. Children aged 10-14.9 years showed considerably higher mean Hb levels (10.30 ± 0.29 to 10.90 ± 0.26) compared to other age groups in the survey (p<0.05). Malaria-infected children aged 5–9.9 years had significantly decreased PCV and Hb levels (p<0.05) compared to the control group. Changes in serum sodium ion concentrations (Na+, SGOT, ALP, and SGPT) may not be linked with 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% C.I.) and 9.2% (4.7 – 17.1 95% C.I.), respectively, while the prevalence among malaria parasite infected children was 21.4% and 7.4% in the community and hospital.