Malaria morbidity and mortality in children under three years of age on the coast of Benin, West Africa

Malaria morbidity and mortality were measured in a population of 1500 children under 3 years of age from April to December 1989. During monthly home visits, an average of 26 children in 1000 had fever, of whom 15 had parasitaemia. Children less than 6 months old had significantly fewer fever episodes, whether associated with parasitaemia or not. Overall, prevalence of fever with parasitaemia rose steadily from April to August, then decreased but reached a second peak in November. Peaks coincided with the 2 rainy seasons in April to June and September to October. Comparison with a control group demonstrated that children with parasitaemia exceeding 1000 infected red blood cells per microlitre of blood had fever significantly more often than children with lower levels of parasitaemia. The average number of fever episodes per child per year was 2·4, and 33% of these were estimated to be caused by malaria. All cause mortality was 26/1000/year and the malaria mortality rate was 8/1000/year. Malaria deaths were most frequent in the second year of life.