Malaria and COVID-19 co-infection: a symptom diagnostic challenge in a malaria endemic setting

Abstract

Objective: To determine the prevalence and risk factors for malaria and COVID-19 co-infection. Patients and methods: A total of 135 COVID-19 positive patients were consecutively recruited from the Infectious Diseases Hospital, Olodo, Ibadan, Oyo State. Nasopharyngeal and oropharyngeal swab samples were obtained during hospitalization and tested by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) using the BGI SARS-Cov-2 kit (China). Blood was also obtained by needle prick and malaria tests were performed using the SD BIOLINE Malaria Ag P.f/Pan test. Risk factors were entered into individual case investigation forms. Results: Malaria and COVID-19 co-infection rate was 7%. The predominant clinical manifestation was fever (28.1%) and the study showed that COVID-19 and malaria co-infection was associated with increased odds of fever compared to COVID-19 mono-infection (p-value=0.415, OR=4.960). Significant risk factors for malaria/COVID-19 are age of participants (p= 0.000) and CT values for by SARS-Cov2 RTPCR (p=0.013). Fever is a common symptom in either malaria or COVID-19 infection thus posing a diagnostic challenge. Proper risk assessment of febrile patients and laboratory evaluation for COVID-19 and/ or malaria is a prerequisite for appropriate distinction.