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In-hospital morbidity and mortality due to severe malarial anemia in western Kenya

Charles O Obonyo1, John Vulule, Willis S Akhwale

  • 1Centre for Vector Biology & Control Research, Kenya Medical Research Institute, Kisumu, Kenya. Cobonyo@kisian.mimcom.net

The American Journal of Tropical Medicine and Hygiene
|January 31, 2008
PubMed

Insights

Severe malarial anemia (SMA) significantly contributes to deaths in young children in sub-Saharan Africa. This study highlights SMA

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Severe malarial anemia (SMA) is a major cause of illness and death in children in sub-Saharan Africa.
  • Its exact impact on malaria-related mortality remains unclear.

Purpose of the Study:

  • To determine the contribution of SMA to in-hospital mortality in children under 5 years old.
  • To assess the association between SMA, malaria parasitemia, and mortality.

Main Methods:

  • Retrospective review of clinical records for 1,116 children under 5 years admitted to Siaya district hospital, Kenya.
  • Analysis of demographic data, malaria parasitemia, anemia status, blood transfusion rates, and mortality outcomes.

Main Results:

  • 86% of admissions were under 3 years; 83% had malaria, 86% were anemic, and 21% severely anemic.
  • Severe anemia was linked to malaria parasitemia in 85% of cases and contributed to 53% of malaria-related deaths.
  • Overall mortality was 7.5%, with 66% of deaths malaria-related, 12% due to severe anemia, and 89% in children under 3 years. Blood transfusions did not reduce mortality.

Conclusions:

  • Children under 3 years are at high risk for severe anemia and mortality in high malaria transmission areas.
  • SMA is a significant, under-documented contributor to pediatric mortality in malaria-endemic regions.
  • Further research and interventions targeting SMA in young children are crucial.

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