Malaria and Bacterial Co-Infections: A Study among Children Presenting With Febrile Illnesses in Accra.

Abstract

Background: Malaria predisposes children in areas where malaria is endemic to concurrent bacteraemia. In the tropics, co-infections of both diseases are prevalent and are the leading causes of paediatric hospital admissions, morbidity and mortality. Methods: A cross-sectional study was conducted to investigate the prevalence of co-infection of malaria and bacterial bloodstream infections among 232 children under 13 years who reported to three healthcare facilities in Accra and Dodowa with conditions of febrile illnesses suspected to be malaria. The study was conducted between the months of May and December 2014. Results: Out of 1187 eligible febrile children, only 232 (19.55%) who tested positive for malaria were included in the study. They comprised 121 males and 111 females. Blood and stool specimens were taken for haematological analysis and culture for the identification of pathogenic bacteria after malaria diagnosis. Descriptive data were summarised and chi-square analysis was used in testing for associations. Fever (76.72%), anaemia (69.39%) and vomiting (49.56%) were the commonest symptoms of clinical visits. Of the 232 children tested, blood cultures were positive in 5.6% (13/232) for bacterial agents and there were no bacteria isolated from stool cultures. Anaemia, parasitaemia and white blood cell counts were high but not associated with co-infection after chi-square analysis. Co-infection of malaria and bacteraemia was associated with children who never patronised food from outside their homes. Other risk factors were in high frequencies but were not associated with co-infections. Conclusion: These results may suggest co-infection of bacteraemia and malaria, however non-typhoidal Salmonella may not be associated with malaria in the present study.