Malarial parasitaemia in febrile children with sickle cell anaemia

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 ≥38.3°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. © 1992 Oxford University Press.