High prevalence and clinical profile of malaria in a hyperendemic area of Mali in 2021

Abstract

Introduction: The WHO African Region recorded 246 million malaria cases in 2023, about 94% of global cases. In Mali, malaria is the leading cause of consultations in health centers (39%). The national strategy focuses on prevention and case management. Knowledge of disease indicators is essential to adapt control strategies. Methodology: We conducted a prospective cross- sectional study at Fakola's community healthcare center, in an endemic area, from June to November 2021. A questionnaire collected clinical, biological, and sociodemographic data. Data were entered in Excel 2016 and analyzed using Epi Info 7. Diagnosis was based on the OnSite™ "Malaria Pf/Pan Ag Rapid Test" Kit. Results: Among 317 individuals seen, 224 tested positive, giving a malaria frequency of 70.67%. Of these, 52.2% were women. Severe malaria accounted for 29.3% of cases, with Plasmodium falciparum responsible for 98.2%. Most cases occurred in August (24.1%). Fever was the most common symptom (90.6%), followed by severe anemia (5.5%), including 0.6% linked to P. malariae and P. ovale. A significant association was found between non- participation in Seasonal Malaria Chemoprevention (SMC) and severe malaria (p = 0.019). Women and children under 5 were most affected. Other species like P. vivax, P. malariae, and P. ovale were also present in southern Mali. Conclusion: This cross-sectional serosurvey revealed that simple malaria, mainly due to P. falciparum, predominantly affected children under 5. Despite seemingly good SMC coverage, prevalence remained high. The strong correlation between non-participation in SMC and severe malaria highlights the importance of prevention programs.