Malaria in young children

Malaria disproportionately affects children younger than 5 years. P. falciparum malaria is responsible for more than 200. 000 child deaths per year in Africa and P. vivax malaria is well documented as a cause of severe anaemia and excess mortality in children in Asia and Oceania (Ashley and Poespoprodjo, 2020).

The main clinical presentations of malaria in children up to 5 years are divided into uncomplicated malaria and severe malaria (Ashley and Poespoprodjo, 2020).

Regarding uncomplicated malaria, it is characterized by symptoms similar to other systemic infections such as fever associated with chills, drowsiness and irritability, diarrhoea, nausea and vomit, jaundice (Poespoprodjo et al., 2009; Ibhanesebhor, 1995).

If P. falciparum malaria in young children is not treated promptly, it has a rapid evolution from a non-complicated disease to a potentially severe and deathly one. In fact it often leads to cerebral malaria or severe malarial anemia (Mutombo, 2018).

Children up to 5 develop more easily severe malaria than adults because this age group matches with the period when a child has lost maternal antibodies and is gradually develop the necessary immunity to defend themselves against the diseases (Carneiro et al., 2010; Okiro et al., 2009).   

The highest prevalence of these severe forms of P. falciparum malaria in Africa occurs during the rain season. The humidity in fact favors multiplication of the vector responsible for malaria transmission (Oduro et al., 2007; Appawu et al., 2004).

As for pregnant women, the two components of malaria prevention in children up to 5, are reducing exposure to infected mosquitoes and chemoprophylaxis.

To reduce exposition to infected mosquitoes insecticide treated nets are used.

Regarding chemoprophylaxis, The WHO recommends the Seasonal Malaria Chemoprevention (SMC), an intermittent preventive treatment, in areas with highly seasonal malaria transmission as the Sahel sub-region. SMC consists of a complete 3-day treatment course of amodiaquine plus sulfadoxine-pyrimethamine should be given to children aged between 3 and 59 months at monthly intervals, to a maximum of four doses during the malaria transmission season (Schumacher and Spinelli, 2012).

SMC is delivered at fixed or door-to-door delivery visits by community health workers or community relays.

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Keywords:

up to 5 years, maternal antibodies, rain season, Seasonal Malaria Chemoprevention, amodiaquine, sulfadoxine-pyrimethamine, door-to-door delivery.