Prevalence of Malaria Parasites and Co-Infection with Bacteria in Febrile Children at General Hospital Lokoja, Kogi State

Malaria remains the leading cause of febrile illness in Nigerian children, yet co-infections with bacterial pathogens can confound diagnosis and worsen clinical outcomes in settings where both burdens overlap. This study determines the prevalence of malaria parasites and co-existing bacterial infections in febrile children at General Hospital Lokoja, Kogi State, North Central Nigeria. Blood samples were collected from 150 febrile children aged 1 to 12 years, with thick and thin blood film microscopy for malaria parasite identification and density, and blood culture for bacterial isolation on blood agar and MacConkey agar. Malaria prevalence was 58 percent, with Plasmodium falciparum accounting for all confirmed cases. Blood culture positivity was 16 percent overall, rising to 24 percent among children with confirmed malaria, suggesting an elevated bacteraemia risk in malaria co-infection. Salmonella typhi and non-typhoidal Salmonella were the most common blood culture isolates in co-infected children. Haemoglobin levels were significantly lower in co-infected patients than in those with malaria alone. The study identifies the risk of missed bacteraemia in febrile children treated exclusively for malaria in resource-limited settings. Recommendations include concurrent blood culture with malaria testing in children with severe febrile illness and strengthened rational antibiotic prescribing in Kogi State paediatric wards. Keywords: malaria, bacterial co-infection, febrile children, Lokoja, Kogi State