MWJ 2014, 5, 1
This study determined the proportion of acute febrile illness in an urban paediatric population that was due to malaria or respiratory syncytial virus (RSV). A hospital based surveillance system recruited children below five years of age reporting with fever (axillary temperature ≥ 37.5°C). Thick blood film from capillary blood taken through a finger prick, was Giemsa-stained and microscopically examined for malaria parasites to confirm malaria diagnosis. Nasopharyngeal aspirate was also examined for RSV by polymerase chain reaction. Out of 481 febrile children, 51(10.8%) were positive for malaria whilst 75 (15.4%) were positive for RSV. Seven of the 75 RSV-positive cases (9.3%) were co-infected with malaria. Based on judgement by clinicians, over 80% of the febrile children were diagnosed and treated as having malaria either alone or in combination with other diseases. It is concluded that the diagnosis and subsequent treatment of patients based solely on clinical diagnosis leads to an over diagnosis of malaria. Improvement in the guidelines and facilities for the diagnosis of non-malaria febrile illness leads to improved malaria diagnosis.