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Published on: May 30, 2019
Bacteremia in Kenyan children presenting with malaria
T Were1, G C Davenport, J B Hittner
1University of New Mexico/Kenya Medical Research Institute, Laboratories of Parasitic and Viral Diseases, Centre for Global Health Research, Kisumu, Kenya.
Bacteremia in children with malaria significantly increases mortality and malnutrition risks, especially when caused by Gram-negative bacteria. This study highlights the need for better diagnostics and treatment in high-transmission areas.
Area of Science:
- Pediatrics
- Infectious Diseases
- Global Health
Background:
- Bacteremia in children with Plasmodium falciparum malaria is understudied, particularly in holoendemic regions.
- Understanding its impact on clinical outcomes is crucial for effective interventions.
Purpose of the Study:
- To investigate the prevalence, etiologies, and clinical outcomes of bacteremia in malaria-infected children in western Kenya.
- To identify risk factors and associations between bacteremia and clinical parameters.
Main Methods:
- Blood cultures and comprehensive clinical, laboratory, hematological, and nutritional data were collected from 585 children (1-36 months) with malaria.
- Multivariate logistic regression was used to analyze associations between bacteremia and various outcomes.
Main Results:
- Bacteremia prevalence was 11.7% (n=506), with nontyphoidal Salmonella spp. as the most common cause.
- Bacteremia was associated with higher mortality (8.5-fold), malnutrition, elevated glucose, and lower hemoglobin levels.
- Gram-negative bacteremia specifically increased risks of respiratory distress, severe malarial anemia, and underweight.
Conclusions:
- Bacteremia is a significant complication in children with P. falciparum malaria, linked to increased malnutrition and mortality.
- Gram-negative bacteremia poses a particularly high risk for severe clinical outcomes.
- Findings underscore the importance of addressing bacteremia in pediatric malaria management.
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