PATTERNS OF MALARIA MORBIDITY AND MORTALITY IN CHILDREN IN NORTHERN GHANA

A malaria prevalence survey was carried out in young children in north ern Ghana between October 1990 and September 1991, in an area with con tinuous mortality and morbidity surveillance. There was marked seasona l variation in malaria deaths, reported fevers, parasite rates and mea n parasite densities, with parasite rates reaching 85-94% in the wet s eason. The monthly numbers of malaria deaths were highly correlated wi th rainfall in the previous 2 months (r=0.90, P<0001). Parasite rates were highest in the oldest children (5-7 years), but parasite densitie s and rates of febrile illness were highest in those 6-11 months old. Haemoglobin levels were also at their lowest in this age group. The pr edominant species, Plasmodium falciparum, was present in 71% of all bl ood films. Febrile illness was well recognized by mothers, but it was not possible to construct a simple clinical diagnostic algorithm which would identify even 50% of children with high levels of malaria paras itaemia (greater than or equal to 4000 parasites/mu L). Malariometric indicators appear to have changed little in this area since a previous survey in 1955.