Life-threatening malaria in African children: a prospective study in a mesoendemic urban setting - PubMed (original) (raw)
doi: 10.1097/INF.0b013e31815988ed.
Belco Poudiougou, Abdoulaye Traoré, Modibo Keita, Aboubacar A Oumar, Innocent Safeukui, Sandrine Marquet, Sandrine Cabantous, Mahamadou Diakité, Daouda Mintha, Mahamadou B Cissé, Marouf M Keita, Alain J Dessein, Ogobara K Doumbo
Affiliations
- PMID: 18174865
- DOI: 10.1097/INF.0b013e31815988ed
Life-threatening malaria in African children: a prospective study in a mesoendemic urban setting
Stéphane Ranque et al. Pediatr Infect Dis J. 2008 Feb.
Abstract
Background: The population exposed to malaria within African cities has steadily increased. However, comprehensive data on life-threatening malaria features and risk factors in children from urban areas with seasonal malaria transmission, such as in Bamako (Mali), are lacking.
Methods: Children admitted to the Gabriel Touré Hospital in Bamako with severe malarial anemia (SMA) and/or cerebral malaria (CM) were prospectively included in the study. Indicators of either SMA or CM were analyzed using logistic regression; and death hazard ratios (HRs) were estimated through survival analysis.
Results: The study included 455 children: 66% presented with CM, 34% with SMA, 3% with hypoglycemia (HG); 5% with dehydration; 17% with respiratory distress (RD); 25% with splenomegaly; and 92% with hepatomegaly. The children with CM were older than those with SMA. CM was more often associated with dehydration, HG, and RD, whereas SMA was more often associated with splenomegaly. The overall case fatality rate was 16%, and 94% of the children who died had CM. HG [HR: 2.37; 95% confidence interval (CI): 1.04-5.39; P = 0.040], RD (HR: 4.23; 95% CI: 2.46-7.30; P < 10(-6)) and a deep coma with a Blantyre score of less than 3 (HR: 6.78, 95% CI: 2.43-18.91; P < 10(-3)), were all independent predictors of death.
Conclusions: These findings delineate the patterns of severe malaria in children in a West African mesoendemic urban setting. They validate practicable prognostic indicators of life-threatening malaria for use in the limited facilities available in African health centers and provide a frame of reference for further research addressing life-threatening malaria in this setting.
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