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Clinical aspects and outcome of suspected severe pediatric malaria

J Losimba Likwela1, U D'Alessandro, P Donnen

  • 1Faculté de médecine, université de Kisangani, BP 2012, Kisangani, Democratic Republic of Congo. drjoris@yahoo.fr

Medecine Et Maladies Infectieuses
|July 14, 2012
PubMed

Insights

Diagnosis and treatment of severe malaria in children in Kisangani revealed high fatality rates, particularly when diagnostic tests were not performed. Inadequate hospital support hinders effective management of severe childhood infections.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Severe malaria remains a significant cause of childhood mortality in endemic regions.
  • Accurate diagnosis and timely treatment are critical for improving outcomes in pediatric severe malaria cases.

Purpose of the Study:

  • To evaluate the diagnostic and treatment practices for children with clinically suspected severe malaria.
  • To assess the impact of diagnostic methods and hospital organization on patient outcomes in Kisangani.

Main Methods:

  • A prospective study was conducted in two referral hospitals in Kisangani from January 2010 to February 2011.
  • Included children admitted with clinically suspected severe malaria and at least one WHO severity criterion.
  • Diagnostic confirmation relied on thick drop examination (TDE), with data on treatment and outcomes collected.

Main Results:

  • Of 427 children with suspected severe malaria, 37.0% had positive TDE, 46.4% negative, and 17.3% lacked TDE.
  • Prostration (48.0%) and anemia (40.3%) were the most frequent severity criteria.
  • The overall case fatality rate was 19.4%, significantly higher in patients without TDE (70.3%) compared to confirmed cases (7.7%) (P <0.001).

Conclusions:

  • Inadequate technical support and patient management systems can lead to underestimation of severe malaria complications.
  • Effective antimalarial drugs are insufficient if diagnostic and organizational challenges persist.
  • Improving diagnostic capacity and hospital infrastructure is crucial for reducing severe malaria mortality in children.
Abstract

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