Student electives for Jed Bamber, Aoife Casey, Gillian Pickering and Hannah Welstead. (360G-Wellcome-083675_Z_07_Z)

Malaria accounts for 10% of the disease burden of Africa, where it has been estimated to kill a child every 30 seconds. Children in the early years of life are particularly vulnerable to the severe effects of malaria and most of the deaths each year result from P. falciparum infection in young children living in endemic areas. Malawi is one of those endemic areas, which is situated in South East Africa and has a population size of approx. 13 million with an estimated 2.4 million being under 5 years old. Severe malarial anaemia is an important clinical consequence of acute or recurrent malaria. However, other aetiological factors, principally malnutrition, also account for much of the anaemia seen in Africa. One study in neighbouring Kenya looking into the causes of anaemia in children, attributing 46% to Malaria, 25% to Malnutrition, the remainder principally ascribed to gastrointestinal infections such as hookworm. For my elective project, I will travel to the Mzuzu Central Hospital in the Northern Region of Malawi. The hospital serves a population of approximately 150,000. A thick and thin blood film and a haemoglobin level are routinely performed for every child who presents to this Hospital. These data are retained in the hospital case records. I will prospectively audit those results, coupled with the reason for initial presentation, for all children under 5 years admitted to the Hospital for the duration of my elective. This will provide results for approximately 150 children, approximately 35% of whom are likely to have P. falciparum parasitaemia.