Assessment of Malaria and Bacteraemia in Febrile Paediatric Patients from Princess Marie Louise Children Hospital in Accra

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Clinical differentiation between severe malaria and invasive bacterial infection is difficult because of the overlap in disease symptoms. This study compares the number of cases of bacteraemia with malaria infections among febrile paediatric patients. The study also looked at the causative agent of bacteraemia and the antibiotic profile of the isolated bacteria. It also compared clinical diagnosis with laboratory diagnosis. The study was conducted at Princess Marie Louis Children’s Hospital in Accra. Venous blood samples were collected from paediatric patients aged between 5 months to 5 years who were admitted with fever of 38 0C and above, tested for malaria parasitaemia, and cultivated for possible bacterial growth and their antibiotic profile identified. In a total of 182 patients recruited for the study, bacteraemia was 10.2 % and malaria infection was 21.6 %. Malaria and bacteraemia co-infection was 2.8%. There was a weak linear correlation between clinical diagnosis and laboratory diagnosis of malaria and bacteraemia using Student T-test analysis, thus, 0.215 with P < 0.01 and 0.184 with P < 0.05 respectively which implies a very little evidence to infer that clinical diagnosis and laboratory diagnosis of patients with fever provided similar results. The most occurring organisms were Coagulase Negative Staphylococcus, Staphylococcus aureus and Salmonella paratyphi B. The antibiotic profile indicated that Staphylococcus aureus and Coagulase Negative Staphylococcus (CNS) were all resistant to Penicillin class antibiotics. Pseudomonas spp. had 100% resistance to chloramphenicol, cotrimoxazole and gentamycin. Salmonella paratyphi B also showed 100% resistance to chloramphenicol and tetracycline and 40% resistance to cotrimoxazole and gentamicin. The presence of antibiotic resistant pathogens in our environments has also been highlighted in this study. A continuation of this study involving other hospitals and a larger sample size will provide more data on these resistant pathogens and their distribution which will contribute to health care policy planning in Ghana and the sub-region at large.
A Thesis Submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the Degree of Master of Philosophy in Clinical Microbiology, June-2013