Research

Confusing bacteremias and severe malaria

In sub-Saharan Africa, it is common practice to treat all children with fever for malaria. If they don’t get better within a few days, other causes for the disease are considered.

Infant with severe malaria in a tertiary referral hospital in Africa (Photography: Mika Väisänen).
Infant with severe malaria in a tertiary referral hospital in Africa (Photography: Mika Väisänen).

In the past years, we have found that many children diagnosed with severe malaria have bacteria in their blood. As they are only treated for malaria, bacteremias progress rapidly and 50% of these cases are fatal. Diagnosing bacteremias requires blood cultures and these are too laborious and expensive for most settings in malaria-endemic countries. Hence, we searched for simple methods to differentiate severe malaria from bacterial blood infections. In rural Ghana, we have found that among 1915 children with high fever and malaria parasites in their blood, 46 (6%) had bacteremias, mostly salmonellae and streptococci. Unfortunately, we did not identify any simple clinical signs that in practice could help to identify the latter group for antibiotic treatment. Because of the great clinical relevance of bacteremias, we continue our work by searching for serum markers.

 


Nielsen M.V. et al., PLoS One 2015, 10(4):e0122139;

Maja Nielsen, Solomon Amemasor, Alex Agyekum, Wibke Loag, Nimako Sarpong, Denise Dekker, Jürgen May and external co-operation partners (see publication)