Distribution and Prevalence of Severe Malaria in Oyo State, South-Western Nigeria, 2011 -2013
Malaria is a major public health concern. Severe Malaria (SM) as its complicated form accounts for an estimated 670,000 deaths annually. Sub-Saharan Africa accounts for 80-90% of these fatalities. In Nigeria, efforts are directed at reducing the burden of this disease. We conducted this study in Oyo State South-western Nigeria to determine the distribution of SM in clinic attendees.
METHODS:
The 2011-2013 Integrated Disease and Surveillance Response SM specific data from 528 public health facilities, across the 33 local government areas of the state was reviewed. We defined a SM case as any individual in Oyo state from 2011-2013 with severe febrile disease diagnosed clinically or laboratory confirmed P. falciparum asexual parasitaemia with accompanying symptoms and signs of severe disease and vital organ dysfunction. Pregnant women were excluded. Descriptive analysis of cases was done using Microsoft Excel 2007.
RESULTS:
Clinically diagnosed and confirmed malaria (uncomplicated, severe and malaria in pregnancy) cases in this period totaled 1,578,825.We extracted 32,351 SM cases: 9,532, 10,823 and 11,996 in 2011, 2012 and 2013 respectively. There were 10,599 cases (34%) in children below 5years and 21,492 (66%) in persons above 5years. Out-patients and In-patients accounted for 16,870 (52%) and 15,571 (48%) cases. A total 84 SM deaths were recorded; 4 (5%) and 80 (95%) in persons below 5years and above 5years respectively. Case Fatality Rates (CFR) were 0.2% in 2011, 0.3% in 2012 and 0.4% in 2013. The prevalence of SM estimated was 3%, 2% and 2% in 2011, 2012 and 2013.
CONCLUSIONS:
The burden of severe malaria is higher in persons above 5 years in outpatient clinics of public health facilities in Oyo state, with yearly progressive increase in cases and CFR. We recommend early diagnosis, accompanying effective and timely case management of uncomplicated malaria which will prevent disease progression and improve prognostic indicators.