Predictive indices of empirical clinical diagnosis of malaria among under-five febrile children attending paediatric outpatient clinic

• Published in: Annals of tropical medicine and public health Vol. 8; no. 2; p. 28
• Main Authors: Elechi, Hassan, Rabasa, Adamu, Alhaji, Muhammad, Bashir, Muhammad, Bukar, Lawan, Askira, Umoru
• Format: Journal Article
• Language: English
• Published: Accra Medknow Publications and Media Pvt. Ltd 01.03.2015; Medknow Publications & Media Pvt. Ltd
• Subjects: Ambulatory care facilities; Child health; Diagnosis; Malaria; Pediatrics; United States
• ISSN: 1755-6783; 0974-6005
• DOI: 10.4103/1755-6783.157275

Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO) recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6%) were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5%) of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5%) were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.