Background: Malaria is one of the most serious and complex health problems in Sub Saharan Africa. Anemia in Children with malaria may require blood transfusion and has been be associated with high mortality rates. Aim: The aim of this study is to evaluate the prevalence, pattern, and severity of malaria parasitemia among children 6 months to 14 years old, requiring blood transfusion. Subjects and Methods: This is a cross‑sectional study carried out at the children emergency unit of the Imo state University Teaching Hospital South East Nigeria. Data were analyzed using SPSS version 21, Chicago Il, USA Results: A total of 409 children were recruited into the study. The overall rate of malaria parasitemia was 83.1% (340/409) lower in males 81.6% (228/276) than in females 86.3% (112/133). The peak of parasitemia is similar in both sexes (5‑9 years). Most of the children had medium levels of parasitemia, which decreased with increasing age. The proportion of children transfused also decreased with increasing age. At medium and high levels of parasitemia; in children below 5 years, 92.8% (132/142) were transfused while in 5 years and above only 79.6% (39/49) of the children were transfused. At medium level parasitemia the proportion of children transfused was significantly higher than those not transfused (P < 0.001). Conclusion: Most children 6 months to 14 years with medium level of parasitemia may require blood transfusion. Targeted measures toward primary prevention of malaria in children should be intensified as this will not only reduce morbidity and mortality of malaria, but will reduce the economic burden of the disease in Semi‑rural and rural dwellers in Sub Saharan Africa.
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