Malaria and Bacteremia in Febrile Children Presenting at a Teaching Hospital in Kumasi, Ghana

Background Fever is a common symptom of various diseases but is frequently assumed to be caused by malaria in many malaria-endemic regions. As a result, many individuals seek malaria treatment without confirming diagnosis, potentially overlooking other serious infections. Notably, febrile children may also suffer from bacteremia, which, if undiagnosed, can lead to severe complications. This study, therefore, sought to assess the prevalence of both malaria and bacterial infections among febrile children receiving care at Komfo Anokye Teaching Hospital (KATH) in Ghana. Methods This cross-sectional study involved 270 febrile children presenting at KATH between April 2022 and July 2023. Malaria diagnosis and blood culture procedures were performed and bacterial isolates were tested for antibiotic susceptibility. Binary logistic regression analysis was employed to identify independent predictors of malaria-bacterial co-infection. Data analysis was carried out using Statistical Package for Social Sciences (Version 26.0) and GraphPad Prism (version 8.01), with categorical variables presented as frequencies and percentages. statistical significance set at p  < 0.05. Results Malaria and bacteremia were prevalent in 33% and 31% of participants respectively, with coinfection at 10.4%. Seizures were independently associated with increased risk of malaria-bacterial coinfection [adjusted odds ratio (aOR) = 3.57, 95% confidence interval (CI) 1.28–9.95, p = 0.015]. Staphylococcus aureus (43.8%) and Pseudomonas aeruginosa (6.3%) were the most common gram-positive and gram-negative bacterial isolates, respectively. Multi-drug resistance (MDR) bacteria were identified in 34.5% of participants. Conclusion Findings highlight that, approximately, one-tenth of febrile children have malaria-bacterial coinfection, with seizures as a significant risk factor. Multi-drug resistance is common among children with malaria-bacterial coinfection. These findings show the need for effective antibiotic stewardship programs and resistance monitoring programs to prevent the further spread of drug-resistant infections among children.