Objectives: To determine the prevalence of paediatric malaria admissions in an area of stablemalaria transmission and to ascertain the relative contributions of different forms of severemalaria to morbidity and mortality.Design: A descriptive restrospective study.Setting: Olanrewaju hospital, a general practice health facility in a malaria holoendemic cityin Nigeria.Subjects and rnethods: Case files of paediatric (age <15years) admissions between 1/1/98 and31/12/98 with a diagnosis of acute malaria were retrieved and relevant information includingdemographic data, clinical signs, laboratory records, treatments received and diagnosis ondischarge were extracted. Grouped age-associated prevalence rates were calculated;characteristics of different groups were compared using standard statistical methods.Results: Children with Falciparum malaria accounted for 95 (18%) of the 526 medicaladmissions. The proportion of children admitted with severe malaria was significantlyhigher among the under-fives compared to those over five years (p< 0.001; RR=S.36,95 %CI of 2.58 to 11.2). Thirty two (33.7%) children had severe malaria. Fifteen (15.8%) hadconvulsions without coma, 13 (13.68%) had malaria-associated anaemia and four (4.2%)were diagnosed as having had cerebral malaria. Seizures were significantly more frequentin the under-fives (p=0.001, RR=6.0; 95 % CI of 1.8 to 19.6). There was a significant negativecorrelation between age and severe anaemialblood transfusions (p=0.002). Cerebral malariacarried the greatest risk of fatality (CFR=25%; RR=7,95% CI of 1.5 to 91).Conclusion: High prevalence of paediatric malaria admissions in this study underscores themorbidity burden in Nigerian children, especially in under-fives in whom the severe formsare more common. A high incidence of anaemia requiring blood transfusions furtherincreases the risk of paediatric HIV infectionin Nigeria where organised control programmesare rudimentary
