Malaria amongst febrile children: call for a pediatric malaria assessment tool

In 2017, malaria accounted for 435 000 deaths worldwide. Eleven percent (11%) of these deaths occurred in the Democratic Republic of Congo (DRC), where malaria continues to be a leading cause of morbidity and mortality. Children are amongst the most vulnerable to malaria, which causes 40% of childhood deaths in the country. Although many risk factors for developing malaria have been identified, there is a paucity of data available on the sociodemographic risk factors for pediatric malaria. A cross-sectional study including 131 febrile children aged 2 months to 14 years presenting to Heal Africa Hospital due to febrile illness. Guardians of participants answered a questionnaire about household and maternal characteristics, as well as child symptomatology. Malaria status was confirmed via blood smear. Results were analyzed using the chi-square test, likelihood ratios and a logistic regression. The absence of father as head of household (p=0.011) and gestational malaria (p=0.044) were significantly associated with pediatric malaria. This study provides insight into sociodemographic risk factors associated with pediatric malaria in the DRC. While further investigation is required, this study highlights the benefit of considering these factors when approaching the febrile child. A pediatric malaria assessment tool incorporating socio-demographics, symptoms and physical exam findings may guide investigations to reduce unnecessary testing and provide better patient-centred care.