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. 2005 Jan 9:4:1.
doi: 10.1186/1475-2875-4-1.

Severe falciparum malaria in Gabonese children: clinical and laboratory features

Arnaud Dzeing-Ella  1 , Pascal C Nze Obiang, Rose Tchoua, Timothy Planche, Béatrice Mboza, Monique Mbounja, Ulrich Muller-Roemer, Joseph Jarvis, Eric Kendjo, Edouard Ngou-Milama, Peter G Kremsner, Sanjeev Krishna, Maryvonne Kombila
Affiliations

Severe falciparum malaria in Gabonese children: clinical and laboratory features

Arnaud Dzeing-Ella et al. Malar J. .

Abstract

Background: Malaria continues to claim one to two million lives a year, mainly those of children in sub-Saharan Africa. Reduction in mortality depends, in part, on improving the quality of hospital care, the training of healthcare workers and improvements in public health. This study examined the prognostic indicators of severe falciparum malaria in Gabonese children.

Methods: An observational study examining the clinical presentations and laboratory features of severe malaria was conducted at the Centre Hospitalier de Libreville, Gabon over two years. Febrile children aged from 0 to 10 years with Plasmodium falciparum infection and one or more features of severe malaria were enrolled.

Results: Most children presenting with severe falciparum malaria were less than 5 years (92.3% of 583 cases). Anaemia was the most frequent feature of severe malaria (67.8% of cases), followed by respiratory distress (31%), cerebral malaria (24%) hyperlactataemia (16%) and then hypoglycaemia (10%). Anaemia was more common in children under 18 months old, while cerebral malaria usually occurred in those over 18 months. The overall case fatality rate was 9%. The prognostic indicators with the highest case fatality rates were coma/seizures, hyperlactataemia and hypoglycaemia, and the highest case fatality rate was in children with all three of these features.

Conclusions: Prompt and appropriate, classification and treatment of malaria helps identify the most severely ill children and aids early and appropriate management of the severely ill child.

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Figures

Figure 1
Figure 1
Schematic process of the screening of febrile children in the Centre Hospitalier de Libreville, Gabon.
Figure 2
Figure 2
Admission characteristics of the study population (All results are mean ± SD except those specified.
Figure 3
Figure 3
Venn diagram of features of 463 cases with a complete dataset of clinical measures. Case fatality rates shown in brackets.
Figure 4
Figure 4
Prognostic indicators at the time of admission. OR – odds ratio, SD – standard deviation.
See this image and copyright information in PMC

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