EPIDEMIOLOGIC FEATURES OF SEVERE PEDIATRIC MALARIA IN NORTH-WESTERN ETHIOPIA

Malaria remains a major public health challenge in sub-Saharan Africa, yet our knowledge of the epidemiology of malaria in terms of patterns of mortality and morbidity is limited, To examine the clinical and ep idemiological presentation of severe life-threatening malaria in Humer a, north western Ethiopia studies were conducted among the childhood p opulation in the community, those presenting to out-patient facilities and those admitted to the district hospital. The overall P.falciparum parasite rate among children aged 0-9 years resident within the area was only 12% confirming the low level of endemicity in this: area. P. vivax infections were present in 5% of children. Between July 1993 and June 1994 peak out-patient presentation with Plasmodium falciparum co incided with the rains with over 50% of cases occurring between August and October whilst P. vivax infections were predominant during the ho t, dry months, Malaria was an important cause of paediatric admission to the local district hospital with an estimated 4.7% of the at-risk c hildhood community warranting intensive clinical management each year. Case fatality rates were high and the clinical spectrum of severe dis ease indicated a preponderance of cerebral malaria cases. In addition, respiratory distress was a feature in 12% of the malaria admissions, The suggestion that the co-existence of Plasmodium falciparum and Plas modium vivax may serve to reduce the severe clinical consequences of P . falciparum malaria is not supported by these observations.