Malaria Diagnosis at the Pediatric Emergency Unit of a Teaching Hospital in Makurdi, North Central Nigeria.

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Ethiopian Journal of Health Sciences Pub Date : 2024-01-01 DOI:10.4314/ejhs.v34i1.5
A Michael, N B Samba, M G Adikwu, M O Ochoga, J U Akpan, E E Eseigbe
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Abstract

Background: Globally, there were 241 million cases of malaria in 2020, with an estimated 627,000 deaths with Nigeria accounting for 27% of the global malaria cases. In sub-Saharan Africa, testing is low with only 28% of children with a fever receiving medical advice or a rapid diagnostic test in 2021. In Nigeria, there are documented reports of over-diagnosis and over-treatment of malaria in children. Therefore, this study examined the diagnosis of malaria at the Benue State University Teaching Hospital, Makurdi.

Methods: A 5-year (2018-2022) retrospective study was carried out at the Emergency Pediatric Unit (EPU). Records of all children presenting to the EPU with an assessment of malaria were retrieved and reviewed. Data was analyzed using SPSS 23.

Results: Out of 206 children reviewed, 128 (62.1%) were tested using either malaria RDT or microscopy while 78(37.9%) were not tested. Out of the number tested, 59(46.1%) were negative while 69(53.9%) tested positive, of which 14(20.3%) had uncomplicated malaria while 55(79.7%) had severe malaria. However, while 97.1% (n=67) of the positive cases were treated with IV artesunate, 69.5% (n=41) of those who tested negative and 88.5% (69) of those who were not tested also received IV artesunate. Moreover, while 85.5% (n=59) of those who tested positive received oral artemisinin-based combination therapy (ACT), 72.9% (n=43) of those who tested negative and 67.9% (53) of those who were not tested also received oral ACT.

Conclusion: There was over-diagnosis of malaria, and subsequently, over-treatment. Hence continued emphasis on parasitological confirmation of malaria before treatment is recommended.

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尼日利亚中北部马库尔迪一家教学医院儿科急诊室的疟疾诊断。
背景:2020 年全球疟疾病例将达到 2.41 亿例,估计有 62.7 万人死亡,其中尼日利亚占全球疟疾病例的 27%。在撒哈拉以南非洲,检测率很低,2021 年只有 28% 的发烧儿童接受了医疗建议或快速诊断检测。在尼日利亚,有文献报道存在过度诊断和过度治疗儿童疟疾的情况。因此,本研究考察了马库尔迪贝努埃州立大学教学医院的疟疾诊断情况:在儿科急诊室(EPU)开展了一项为期 5 年(2018-2022 年)的回顾性研究。研究人员检索并审查了所有在儿科急诊室就诊并被评估为患有疟疾的儿童的记录。数据使用 SPSS 23 进行分析:在接受复查的 206 名儿童中,128 人(62.1%)接受了疟疾 RDT 或显微镜检测,78 人(37.9%)未接受检测。在接受检测的人数中,59 人(46.1%)检测结果呈阴性,69 人(53.9%)检测结果呈阳性,其中 14 人(20.3%)为无并发症疟疾,55 人(79.7%)为重症疟疾。不过,虽然 97.1%(67 人)的阳性病例接受了青蒿琥酯静脉注射治疗,但 69.5%(41 人)的阴性病例和 88.5%(69 人)的未检测病例也接受了青蒿琥酯静脉注射治疗。此外,85.5%(n=59)检测呈阳性的患者接受了口服青蒿素综合疗法(ACT),72.9%(n=43)检测呈阴性的患者和 67.9%(53)未接受检测的患者也接受了口服青蒿素综合疗法:结论:存在疟疾诊断过度和治疗过度的情况。因此,建议在治疗前继续强调疟疾的寄生虫学确认。
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来源期刊
Ethiopian Journal of Health Sciences
Ethiopian Journal of Health Sciences HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.10
自引率
8.30%
发文量
137
审稿时长
12 weeks
期刊介绍: Ethiopian Journal of Health Sciences is a general health science journal addressing clinical medicine, public health and biomedical sciences. Rarely, it covers veterinary medicine
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