Impact of COVID-19 on outcomes of childhood severe malaria: A comparative of study pre-COVID-19 and COVID-19 periods

Author:

Ibrahim Olayinka Rasheed1,Alao Michael Abel2,Suleiman Bello Mohammed3,Mokuolu Olugbenga Ayodeji4

Affiliation:

1. University of Ilorin Teaching Hospital

2. University College Hospital, & University of Ibadan

3. Federal Teaching Hospital, Katsina,

4. University of Ilorin Teaching Hospital, & University of Ilorin

Abstract

Abstract Background The collateral damages from measures adopted to mitigate the COVID-19 pandemic have been projected to impact negatively on malaria in sub-Saharan Africa. Herein, we compared the prevalence and outcomes of childhood severe malaria during pre-COVID-19 and COVID-19 periods at a tertiary health facility in Nigeria. Methods This was a retrospective review of cases of severe malaria admitted from 1st January to 31st December 2019 (pre-COVID-19 period) and 1st January to 31st December 2020 (COVID-19 period). We extracted relevant information including demographics, duration of symptoms before presentation, forms of severe malaria, and outcomes of hospitalization (discharged or death). Results In the pre-Covid period, there were a total of 2312 admissions to the EPU and 1685 in the covid period representing a decline of 27%. In contrast, there were 263 and 292 severe malaria admissions in the pre-COVID-19 and COVID-19 periods, respectively, representing an 11% increase in the absolute number of cases. The prevalence rates were 11.4% in the pre-COVID-19 period and 17.3% in the COVID-19 period representing an increase of 52% in the percentage differences. The mortality rate in COVID-19 period was higher than the pre-COVID-19 period ([10.3%;30/292 vs 2.3% 6/263], p < 0.001). The death rate increased by 350.0% during the COVID-19 period. A child is five times more likely to die from severe malaria in the COVID-19 era than in pre-COVID time (4.9, 95% CI 2.008, 11.982). In the COVID-19 era, presentation at a health facility was also delayed (p = 0.029), as were the odds of multiple features of severe malaria manifestations (p = 0.020). Conclusion. This study shows that the prevalence of severe childhood malaria increased by as high as11.0%, with a disproportionate increase in mortality compared to the pre-pandemic level. Most children with severe malaria presented late with multiple features of severe malaria probably contributing to the poor hospitalization outcomes (death) observed in this study.

Publisher

Research Square Platform LLC

Reference23 articles.

1. World Health Organization. Malaria Fact Sheet. Malaria Fact Sheet. 2022;:1–7. https://www.who.int/news-room/fact-sheets/detail/malaria. Accessed 5 Aug 2022.

2. Malaria: Global progress 2000–2015 and future challenges;Cibulskis RE;Infect Dis Poverty,2016

3. World health Organization. World malaria report 2020: 20 years of global progress and challenges. Geneva; 2020.

4. Malaria burden and pre-hospital medication among subjects with malaria in Maiduguri, Northeast Nigeria;Balogun ST;Heliyon,2019

5. USAID. U.S. President’s Malaria Initiative Nigeria Malaria Operational Plan FY 2022. 2022.

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