Reported incidence of fever for under-5 children in Zambia: a longitudinal study

Archives of Public Health

Benson M. Hamooya²  Gershom Chongwe²  Lungowe Sitali¹  Hikabasa Halwindi² 

[1] Department of Biomedical Sciences, The University of Zambia, School of Medicine, Lusaka, Zambia

[2] Department of Public Health, The University of Zambia, School of Medicine, Lusaka, Zambia

关键词: Longitudinal study;    Under five children;    Incidence;    Malaria;    Fever;   

Others  :  1234992
DOI  :  10.1186/s13690-015-0097-5

 received in 2015-08-10, accepted in 2015-09-22,  发布年份 2015

【 摘 要 】

Background

Childhood fever is the most common clinical sign of Plasmodium falciparum infection. It is used as a measure of burden of the disease and the effectiveness of control programs for malaria. This study aimed to determine the incidence of fever in under-5 children of Magoye and Chivuna rural areas of Mazabuka district, Zambia.

Methods

Incidence of fever was evaluated longitudinally over a period of 16 months (July 2006 and November 2007) among children aged 12–59 months in Magoye and Chivuna rural communities. The data was collected for a study on community directed treatment of soil-transmitted helminth infections in under-five children. Data from caretakers of 1221 children were collected using a structured interviewer-administered questionnaire. Cox proportion hazard regression was used to determine predictors of multiple episodes of fever and Kaplan-Meier survival curves was used to compare survival between two groups.

Results

A total of 1221 under-5 children [median age 32 months; IQR 12–58] participated in the study and 696 (57 %) were from Magoye and 525 (43 %) from Chivuna. The incidence rate of fever was 162.4 per month per 1000 children for the 16 months period. The proportion of fever was not statistically related to children’ age [p = 0.779] and sex [p = 0.546]. Predictors of multiple episodes of fever were: age (37–48 vs. 12–24 months) [HR 0.81; 95 % CI 0.67, 0.98; p = 0.030]; location (Chivuna vs. Magoye) [HR 1.35; 95 % CI 1.17, 1.56; p < 0.001]; and season (dry vs. rainy) [HR 0.17; 95 % CI 0.12, 0.23; p < 0.001].

Conclusion

The study has shown that the incidence of fever was high in the study areas. Febrile illnesses like malaria still have a significant effect on the health of under-5 children in the study population. There still exists the need for interventions aimed at reducing the incidence of fever in under five children, more especially in rural areas.

【 授权许可】

   
2015 Hamooya et al.

【 图 表 】

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【 参考文献 】

• [1][www.philanthropyadvisoryservice.org] webciteMalaria report, “Malaria Disease Report. The FasterCures Philanthropy Advisory Service FasterCures / The Center for Accelerating Medical Solutions 1101 New York Ave. St., NW, #620 Washington, D.C. 20005 (202) 336–8900 ,” 2009. [Online]. Available: . [Accessed: 17-Apr-2015].. http://www.fastercures.org/assets/Uploads/MalariaDiseaseReport.pdf webcite
• [2]Molyneux CS, Mung’ala-Odera V, Harpham T, Snow RW: Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya. Trop Med Int Health 1999, 4(12):836-45.
• [3]Tarimo DS, Lwihula GK, Minjas JN, Bygbjerg IC: Mothers’ perceptions and knowledge on childhood malaria in the holendemic Kibaha district, Tanzania: implications for malaria control and the IMCI strategy. Trop Med Int Health TM IH 2000, 5(3):179-84.
• [4]Uzochukwu BSC, Onwujekwe EO, Onoka CA, Ughasoro MD: “Rural–urban Differences in Maternal Responses to Childhood Fever in South East Nigeria,”. PLoS One 2008, 3:3.
• [5]Oyekale AS: Assessment of Malawian Mothers’ Malaria Knowledge, Healthcare Preferences and Timeliness of Seeking Fever Treatments for Children Under Five. Int J Environ Res Public Health 2015, 12(1):521-40.
• [6]Shayo EH, Rumisha SF, Mlozi MRS, Bwana VM, Mayala BK, Malima RC, Mlacha T, Mboera LEG: Social determinants of malaria and health care seeking patterns among rice farming and pastoral communities in Kilosa District in central Tanzania. Acta Trop 2015, 144:41-9.
• [7]Olotu A, Fegan G, Williams TN, Sasi P, Ogada E, Bauni E, Wambua J, Marsh K, Borrmann S, Bejon P: “Defining Clinical Malaria: The Specificity and Incidence of Endpoints from Active and Passive Surveillance of Children in Rural Kenya. PLoS One 2010, 5:12.
• [8]WHO Factsheet, “WHO Factsheet on the World Malaria Report 2014,” WHO, 2014. [Online]. Available: http://www.who.int/malaria/media/world_malaria_report_2014/en/. [Accessed: 03-Mar-2015].
• [9]World Malaria Report, “WHO World Malaria Report,” WHO, 2014. [Online]. Available: http://www.who.int/malaria/publications/world_malaria_report/en/. [Accessed: 03-Mar-2015].
• [10]World Malaria Report, “WHO World Malaria Report 2013,” WHO, 2013. [Online]. Available: http://www.who.int/malaria/publications/world_malaria_report_2013/report/en/. [Accessed: 09-Mar-2014].
• [11]Yeboah-Antwi K, Pilingana P, Macleod WB, Semrau K, Siazeele K, Hamainza B, Seidenberg P, Mazimba A, Sabin L, Kamholz K, Thea DM, Hamer DH: “Community case management of fever due to malaria and pneumonia in children under five in Zambia: a cluster randomized controlled trial. PLoS Med 2010, 7(9):e1000340.
• [12]Malaria control centre/ministry of health, “Progress and impact of malaria control in Zambia at a glance: Roll back Malaria,” 2011. Available from: [Accessed 25 March 2014].
• [13]MalariaCare, “Achieving universal diagnosis and appropriate treatment of malaria in Zambia,” MalariaCare, 2014. Available from: [Accessed 6 March 2015].
• [14]Ehrhardt S, Burchard GD, Mantel C, Cramer JP, Kaiser S, Kubo M, Otchwemah RN, Bienzle U, Mockenhaupt FP: Malaria, Anemia, and Malnutrition in African Children—Defining Intervention Priorities. J Infect Dis 2006, 194(1):108-14.
• [15]Ouédraogo A, Tiono AB, Diarra A, Sanon S, Yaro JB, Ouedraogo E, Bougouma EC, Soulama I, Gansané A, Ouedraogo A, Konate AT, Nebie I, Watson NL, Sanza M, Dube TJT, Sirima SB: “Malaria Morbidity in High and Seasonal Malaria Transmission Area of Burkina Faso,”. PLoS One 2013, 8(1):e50036.
• [16]Africa IRSZambia: “Zambia- Africa Indoor Residual Spray Project,” Africa IRS 2014, 14(1):345.
• [17]WHO, “WHO fact sheet on malaria providing key facts, definition, information on transmission, symptoms, who is at risk, diagnosis, treatment, prevention, insecticide resistance, surveillance, elimination, vaccines and WHO response.,” WHO, 2015. [Online]. Available: http://www.who.int/mediacentre/factsheets/fs094/en/. [Accessed: 19-May-2015].
• [18]Tiono AB, Kabore Y, Traore A, Convelbo N, Pagnoni F, Sirima SB: Implementation of Home based management of malaria in children reduces the work load for peripheral health facilities in a rural district of Burkina Faso. Malar J 2008, 7:201. BioMed Central Full Text
• [19]Nuruddin R, Hadden WC, Petersen MR, Lim MK: Does child gender determine household decision for health care in rural Thatta, Pakistan? J Public Health 2009, 31(3):389-97.
• [20]WHO, “WHO Gender, health and malaria,” WHO, Jun-2007. [Online]. Available: http://www.who.int/gender/documents/malaria/gender_malaria_leaflet/en/. [Accessed: 28-Jan-2015].
• [21]Saúte F, Aponte J, Almeda J, Ascaso C, Vaz N, Dgedge M, Alonso P: Malaria in southern Mozambique: incidence of clinical malaria in children living in a rural community in Manhiça district. Trans R Soc Trop Med Hyg 2003, 97(6):655-60.
• [22]Owusu-Agyei S, Asante KP, Adjuik M, Adjei G, Awini E, Adams M, Newton S, Dosoo D, Dery D: A. Agyeman-Budu, and others, “Epidemiology of malaria in the forest-savanna transitional zone of Ghana,”. Malar J 2009, 8(1):220. BioMed Central Full Text
• [23]Malaria in Children report, “Malaria in Children Malaria Site,” 2015. Available from: [Accessed 15 April 2015].
• [24]Holtz TH, Marum LH, Mkandala C, Chizani N, Roberts JM, Macheso A, Parise ME, Kachur SP: Insecticide-treated bednet use, anaemia, and malaria parasitaemia in Blantyre District, Malawi. Trop Med Int Health TM IH 2002, 7(3):220-30.
• [25]Koram KA, Owusu-Agyei S, Fryauff DJ, Anto F, Atuguba F, Hodgson A, Hoffman SL, Nkrumah FK: Seasonal profiles of malaria infection, anaemia, and bednet use among age groups and communities in northern Ghana. Trop Med Int Health TM IH 2003, 8(9):793-802.
• [26]Osuorah DC, Ezeudu CE, Onah SK, Anyabolu OT: “Household bed net ownership and use among under-5 children in Nigeria.,”. Res Rep Trop Med 2013, 4:7-13.
• [27]Atieli HE, Zhou G, Afrane Y, Lee M-C, Mwanzo I, Githeko AK, Yan G: Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya. Parasit Vectors 2011, 4:113. BioMed Central Full Text
• [28]Kassile T: “Prevention and management of malaria in under-five children in Tanzania: a review,”. Tanzan J Health Res 2012, 14:3.
• [29]Oresanya OB, Hoshen M, Sofola OT: “Utilization of insecticide-treated nets by under-five children in Nigeria: Assessing progress towards the Abuja targets. Malar J 2008, 7(1):145. BioMed Central Full Text
• [30]Noor AM, Kirui VC, Brooker SJ, Snow RW: The use of insecticide treated nets by age: implications for universal coverage in Africa. BMC Public Health 2009, 9:369. BioMed Central Full Text
• [31]Deressa W, Fentie G, Girma S, Reithinger R: Ownership and use of insecticide-treated nets in Oromia and Amhara Regional States of Ethiopia two years after a nationwide campaign. Trop Med Int Health 2011, 16(12):1552-61.
• [32]Einterz EM, Bates ME: “Fever in Africa: do patients know when they are hot?,”. Lancet 1997, 350(9080):781.
• [33]Mbonye AK, Lal S, Cundill B, Hansen KS, Clarke S, Magnussen P: Treatment of fevers prior to introducing rapid diagnostic tests for malaria in registered drug shops in Uganda. Malar J 2013, 12:131. BioMed Central Full Text
• [34]P. Brasseur, C. Raccurt, M. Badiane, M. Cisse, J.-F. Trape, and C. Sokhna, “[Changes in malaria prevalence and management of fevers from 2000 to 2012 in Casamance, Senegal.],” Bull. Soc. Pathol. Exot. 1990, Nov. 2014 [Epub ahead of print].