Characteristics of febrile children in a malaria/hiv co- endemic region of Western Kenya

Abstract

Background: Fever is still a priority health problem in the paediatric population. The cause of fever in children in resource-limited settings is not always investigated and thus clinical characteristics are relied on to make presumptive diagnosis especially for malaria. Objectives: To determine the demographic, clinical and haematological this community as it appears cotrimoxazole prophylaxis does not confer additional benefit to those with HIV. characteristics of febrile children in the context of their HIV and malaria parasitemia status. Design: A cross-sectional comparative hospital based study was carried out on febrile children seeking care in the ambulatory clinics. Setting: Webuye Sub-County Hospital in western Kenya. Main Outcomes: Demographic and clinical characteristics for those who met the inclusion criteria. Malaria parasitemia using blood slide and haematological characteristics based on complete blood count. Results: A total of 282 febrile HIV-infected and 332 Non-HIV-infected were recruited into the study. Prevalence of malaria parasitemia was 84% and 51.2% among HIV-infected and the non-HIV-infected febrile children respectively. Of the HIV-infected, 97% were on cotrimoxazole. The HIV-infected were significantly older than the non-infected with a median age of 59 (IQR43, 89) and 48(IQR36, 60) months respectively. Splenomegaly, hepatomegaly and anaemia were more common among the HIV-infected (p-value 0.000, 0.0001 and 0.000 respectively). However, these HIV-infected children had generally more favourable haematological parameters (haemoglobin & MCV) compared to the HIV-non- infected (p-value≤0.0001). Conclusion: HIV infected children with malaria parasitemia were significantly older than non-HIV infected in western Kenya. The HIV infected children however had better haematological parameters compared to the non-HIV infected. There is need to intensify other preventive measures for malaria in