MALARIAL PARASITEMIA IN FEBRILE CHILDREN WITH SICKLE-CELL-ANEMIA

One-hundred-and-sixty-six episodes of fever in 162 children with sickle cell anaemia (SCA) aged 6 months to 16 years, presenting to the childrens emergency room of the University of Benin Teaching Hospital, Nigeria with rectal temperature greater-than-or-similar-to 38.3-degrees-C were studied for malarial parasitaemia. Non-sicklers of similar ages and with similar temperatures were also studied as controls. Malarial parasitaemia was documented in 9 per cent of children with sickle cell anaemia, and 29 per cent of controls (P < 0.0001). Bacteraemia occurred in 33 per cent of children with SCA and 26 per cent of controls (P > 0.10). Bacteraemia was, therefore, the commonest cause of pyrexia in febrile children with sickle cell anaemia on antimalarial prophylaxis. It is suggested that children with SCA on regular anti-malarial prophylaxis who present with significant pyrexia should be carefully screened for bacterial infection and appropriate anti-microbial therapy instituted.