Malaria Among Children in Yemen Straining Country’s Health Services, Study Says

Severe malaria in children is putting a strain on health services in Yemen, and the pattern of the disease is comparable to that in Africa, according to a study published recently in BMJ, ITP reports. Yemen has the second-highest incidence of malaria in the Middle East, and the disease accounts for 40% of hospital admissions during the highest malaria seasons, ITP reports. Abdullah Al-Taiar of Sana'a University in Yemen and colleagues conducted a prospective observational study of childhood malaria at two hospital sites -- one in the mountains and one in the coastal plain -- in the province of Taiz. The children were between the ages of six months and 10 years and had been admitted to hospital between November 2002 and August 2004. The researchers found that out of 8,068 children admitted to the mountain site and 4,233 admitted to coastal plain site, 17% at each site were believed to have severe malaria. In addition, 808 children met the World Health Organization's criteria for severe malaria, according to the study. The researchers also found that younger children had a higher chance of developing severe anemia, cerebral malaria was diagnosed in 8% of participants and about 40% of participants had respiratory distress. The mortality rate among the study participants was 3.2% and was three times higher among girls, with 5.2% of girls dying compared with 1.9% of boys, according to the study. The researchers found that the pattern of severe malaria in Yemen is similar to that in Africa because the incidence rates of the disease during malaria seasons and clinical patterns are almost identical. The researchers suggested that boys might have greater immunity to the disease because they spend more time outside or because of cultural biases. The researchers conclude that "health education is needed if this reflects a delay in the presentation of girls," adding, "Malaria control should be a priority in Yemen, and lessons could be learned from other areas of high seasonal malaria" (Bladd, ITP, 11/8).