Changing pattern of malaria in Bissau, Guinea Bissau

Rodrigues, A; Schellenberg, JA; Kofoed, PE; Aaby, P; Greenwood, B; (2008) Changing pattern of malaria in Bissau, Guinea Bissau. Tropical medicine & international health, 13 (3). pp. 410-417. ISSN 1360-2276 DOI:

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OBJECTIVE To describe the epidemiology of malaria in Guinea-Bissau, in view of the fact that more funds are available now for malaria control in the country. METHODS From May 2003 to May 2004, surveillance for malaria was conducted among children less than 5 years of age at three health centres covering the study area of the Bandim Health Project (BHP) and at the outpatient clinic of the national hospital in Bissau. Cross-sectional surveys were conducted in the community in different malaria seasons. RESULTS Malaria was overdiagnosed in both health centres and hospital. Sixty-four per cent of the children who presented at a health centre were clinically diagnosed with malaria, but only 13% of outpatient children who tested for malaria had malaria parasitaemia. Only 44% (963/2193) of children admitted to hospital with a diagnosis of malaria had parasitaemia. The proportion of positive cases increased with age. Among hospitalized children with malaria parasitaemia, those less than 2 years old were more likely to have moderate anaemia (RR = 1.27; 95% CI: 1.02-1.56) (P = 0.03) or severe anaemia (RR = 1.67; 95% CI: 1.25-2.24) (P = 0.0005) than older children. The prevalence of malaria parasitaemia in the community was low (3%, 53/1926). CONCLUSION In Bissau, the prevalence of malaria parasitaemia in the community is now low and malaria is over-diagnosed in health facilities. Laboratory support will be essential to avoid unnecessary use of the artemisinin combination therapy which is now being introduced as first-line treatment in Bissau with support from the Global Fund.

Item Type: Article
Keywords: malaria epidemiology, overdiagnosis, FEBRILE ILLNESS, MICROSCOPY, TANZANIA, CHILDREN, TRANSMISSION, CHLOROQUINE, PARASITEMIA, MANAGEMENT, AFRICA, ZAMBIA, Anemia, Iron-Deficiency, epidemiology, Child, Preschool, Cross-Sectional Studies, Female, Guinea-Bissau, epidemiology, Humans, Infant, Malaria, Falciparum, epidemiology, Male, Parasitemia, epidemiology
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Malaria Centre
PubMed ID: 18298608
Web of Science ID: 254735300014


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