Malaria Epidemiology in PNG Children

After obtaining community support and written parental consent, 190 children aged 1–3 yrs from Ilaita 1–7 and Sunuhu 1 and 2 were enrolled in March 2006. Demographic information was collected from all participating children and the location of each child's home was recorded using a hand-held GPS receiver (Garmin 12XL). Each child was clinically examined: axillary temperature was measured using digital thermometers, spleen palpated and a standard questionnaire of common signs and symptoms of malarial illness was administered. Hemoglobin (Hb) was measured using a portable device (HemoCue®, Ångholm, Sweden). A 5 ml venous blood sample was collected using Heparin-Vacutainer® tubes (Becton Dickinson, NJ, USA) and 2 blood slides (thick and thin films) made for determination of malarial infection. Bed net usage of both mother and child was queried. All children with parasitologically confirmed malaria (see below) were treated with Coartem® (arthemeter-lumefantrine); those with moderate to severe anaemia (i.e. Hb <7.5 g/dl) received an antimalarial treatment (Coartem®) plus 4 weeks of iron and folate supplementation according to national treatment guidelines.
As the initial enrolment did not yield the required sample size, the study area was extended to include Kamanokor and Ingamblis villages and 74 further children were enrolled into the study from the 1^st to the 3^rd regular bleed time points (May to September 2006).Enrolment procedures were identical with the exception of the 5 ml venous blood sample, which was not collected from these later enrolments. A 250 µl finger prick blood sample was collected instead.