Malaria Related Deaths among Children with Manifestations of Fever Symptoms on Admission in a Secondary Health Care Institution in Western Region of Ghana - A Retrospective Study

Background: Malaria is a major contributor to deaths in children especially in sub-Saharan Africa.
Children less than five years of age are susceptible to malaria infection in endemic regions leading to
serious complications. Malaria causes death in children either directly through Cerebral Malaria (CM)
and Severe Malaria Anaemia (SMA) or indirectly through co-morbidity with pneumonia or a sequela
like hypoglycaemia.
Methods: This retrospective study examined malaria-related deaths among children at Effia-Nkwanta
hospital within a study period of 3 years.
Results: A total of 1,416 medical records were reviewed, out of which 223 were medical records of
children with fatal outcomes. Deaths over the study period due to all causes were 15.7% (223/1416)
and confirmed malaria was 13.7% (40/292). Deaths due to all causes and confirmed malaria
decreased from 21.6% and 24.3% in 2010 to 11.1% and 4.4% in 2012, respectively. Anti-malarial
testing was done for 152 of the children with 40 positive and 112 negative results. Seventy-one
children had no malaria testing done on them, with 23.4% in 2010 40.3% in 2011 and 35.5% in 2012.
Anti-malarial treatment was administered to 83% of children who tested negative and 80% of children
without anti-malarial testing.
Conclusion: Deaths in the children declined from 2010 to 2012 in this study. Despite this
improvement, there was poor anti-malarial testing and improper use of anti-malarial treatment.
National malaria programs should ensure improvement in anti-malarial testing and strict adherence to
the anti-malarial treatment protocol.