Low birth weight and incidence of first malaria episode and adherence to malaria treatment protocols in infants in Chikwawa district, Malawi

Abstract

BACKGROUND In Malawi, malaria is a leading cause of infant morbidity and mortality. Low birthweight and fetal anaemia are also a common occurrence. The relationship between birthweight and fetal anaemia and malaria morbidity in infancy is not known. OBJECTIVES To investigate the relationship between incidence of first malaria episode and birthweight and fetal anaemia and to investigate adherence of health workers to Integrated Management of Childhood Illnesses (IMCI) malaria treatment protocol. DESIGN A stratified sample of 561 infants was selected based on low birth weight (LBW, <2.5Kgs), fetal anaemia (FA, Hbcord <12g/dl) and matched controls with normal birth weight (NBW) and no fetal anaemia (NFA). Cases were defined as LBW FA, LBW NFA, and NBW FA. RESULTS Cumulative incidence to first malaria episode did not significantly differ between the study groups and the controls. Sulphadoxine-pyrimethamine (SP) was prescribed to the majority of malaria cases (89.3%). CONCLUSION There is no relationship between birthweight and fetal anaemia and first malaria episode. There is good adherence to IMCI guidelines for malaria treatment.