Malaria with bacteraemia in acutely febrile preschool children without localizing signs: coincidence or association/complication?

Data were collected on 642 preschool children who presented consecutively to casualty with fever and no localizing signs. Four hundred and forty-six (69%) had malaria parasitaemia. The proportion of children with bacteraemia was similar in those children with malaria (43/446, 9.6%) and those without malaria (24/196, 12.2%, P < 0.5). The pathogens in both groups of children were mainly Staphylococcus aureus and coliform bacteria. Although children with malaria/bacteraemia had a significantly higher prevalence of anaemia (P = 0.001), hepatosplenomegaly (P < 0.01) and combination of hepatosplenomegaly and severe anaemia (P = 0.02), compared with children with malaria alone, there was no correlation between the severity of parasitaemia and prevalence of malaria with bacteraemia. The association of malaria with bacteraemia appears to be coincidental.