INTERACTION BETWEEN ACUTE DIARRHEA AND FALCIPARUM-MALARIA IN NIGERIANCHILDREN

Although both malaria and diarrhoea are major public health problems i n developing countries, and separately each has been the subject of in tense research, few studies have investigated the interaction between these two conditions. The interaction between diarrhoea and malaria am ong children aged 4 months to 12 years in two tertiary health-care fac ilities, University College Hospital, Ibadan, and Lagos University Tea ching Hospital, Lagos, Nigeria was studied. In Ibadan, the prevalence of diarrhoea among the cerebral malaria patients on admission was 11.7 % (7/60) compared to 9.3% (215/2312) among other admissions in 1990 (c hi square-0.16; p=0.6913). Similarly, no significant difference in the prevalence of diarrhoea was found between the cerebral malaria patien ts (14.3%) and other patients (16.1%) seen in Lagos in 1992 (chi squar e=0.06, p=0.81). Thus, cerebral malaria does not seem to be associated with an increased or decreased prevalence of diarrhoea when compared with other conditions. The prevalence of malarial parasitaemia among t he 554 diarrhoea patients studied in Ibadan during 1993-1994 was 13.6% compared with 17.9% among the 347 controls (chi square=3.75, p=0.053) . However, of the children with diarrhoea, malarial parasitaemia was m ore common among the dehydrated patients (25.4%) than among the well-h ydrated patients (11.6%) (chi square = 8.11, p=0.004). These data sugg est that diarrhoea is merely coincidental in severe malaria and conver sely, malarial parasitaemia is similarly,coincidental in children with acute diarrhoea, although it may be more frequent among dehydrated di arrhoea patients than well-hydrated ones.