Haemoparasite Co-infections and Clinical Outcomes in Hospitalised Children in Borno State, North East Nigeria: An Analytical Study

Co-infections involving malaria parasites and other haemoparasites in hospitalised children can produce complex clinical syndromes that complicate diagnosis and worsen outcomes, yet their epidemiology in conflict-affected northeastern Nigeria remains inadequately studied. This study investigates haemoparasite co-infections and their association with clinical outcomes in children hospitalised in Borno State, North East Nigeria. An analytical hospital-based cohort design was employed, recruiting 300 children aged 6 months to 14 years admitted with febrile illness to the University of Maiduguri Teaching Hospital and two state specialist hospitals. Peripheral blood was examined by Giemsa-stained thick and thin blood films for Plasmodium, Trypanosoma, and microfilariae. Full blood count, blood glucose, and serum lactate were measured. Logistic regression modelled the association between haemoparasite co-infection status and adverse outcomes including prolonged hospitalisation, intensive care admission, and mortality at 30 days. Recent evidence from 2020 to 2024 documents elevated malaria case fatality rates in Borno State hospitals compared to national benchmarks, partly attributed to delayed presentation, malnutrition, and complex co-infections associated with displacement. This study fills the analytical gap by quantifying the specific contribution of haemoparasite co-infections to clinical severity in this high-risk setting. Findings will be communicated to the Borno State Ministry of Health and the University of Maiduguri Teaching Hospital for clinical management guideline review. Keywords: haemoparasite co-infections, clinical outcomes, hospitalised children, Borno State, febrile illness.