Related Experiment Video
Updated: Mar 16, 2026
A Simple Protocol for Platelet-mediated Clumping of Plasmodium falciparum-infected Erythrocytes in a Resource Poor Setting
Published on: May 16, 2013
The pattern of bacteraemia in children with severe malaria
Stephen M Graham1, James Mwenechanya1, Madalitso Tembo1
1Department of Paediatrics, College of Medicine, University of Malawi, Malawi; Wellcome Trust Research Laboratories and Malaria Project, College of Medicine, University of Malawi, Malawi.
Insights
Bacteraemia, particularly non-typhoidal Salmonella, is a frequent complication in children with severe malaria, especially severe malarial anaemia. This complication, though not significantly increasing mortality, warrants attention in clinical management.
Area of Science:
- Infectious Diseases
- Tropical Medicine
- Pediatrics
Background:
- Bacteraemia is a known complication of severe malaria, potentially increasing mortality.
- Understanding the prevalence and patterns of bacteraemia in severe malaria is crucial for effective management.
Purpose of the Study:
- To determine the rate and pattern of bacteraemia in children with severe malaria.
- To assess the impact of bacteraemia on the case-fatality rate in severe malaria.
- To investigate the rate and pattern of bacteraemia following blood transfusion for severe malarial anaemia.
Main Methods:
- Prospective study of children with severe malaria (N=701) including blood cultures on admission.
- Logistic regression analysis to identify independent associations with bacteraemia and mortality.
- Retrospective analysis of blood cultures from children receiving blood transfusions (N=1712) for fever investigation.
Main Results:
- Bacteraemia occurred in 5.1% of children with severe malaria; non-typhoidal Salmonella (NTS) was the most common pathogen (50% of isolates).
- Bacteraemia rates were higher in severe malarial anaemia without coma (11.2%) compared to cerebral malaria without anaemia (3.2%), linked to NTS.
- Children with bacteraemia had a higher case-fatality rate (22% vs. 15%), though not statistically significant. NTS accounted for 76.3% of post-transfusion bacteraemia.
Conclusions:
- Non-typhoidal Salmonella bacteraemia is a significant and common complication in children with severe malaria, particularly severe malarial anaemia.
- While bacteraemia did not significantly increase mortality in this study, its high prevalence underscores the need for vigilance.
- Bloodstream infections, especially NTS, are a concern following blood transfusions in children with severe malarial anaemia.
Abstract:
Bacteraemia is a recognised complication of severe malaria and may increase mortality. We determined 1) the rate and pattern of bacteraemia in children with severe malaria; 2) the impact of bacteraemia on case-fatality rate; and 3) the rate and pattern of bacteraemia in following blood transfusion for severe malarial anaemia. For the first two objectives, a prospective study was undertaken involving children admitted consecutively to the Malaria Research Project ward between February 1996 and June 1999. Blood culture was performed on admission. Independent associations with bacteraemia and mortality were determined by logistic regression. Of 701 children with a final diagnosis of severe malaria, 36 (5.1%) had bacteraemia. A wide range of bacteria was isolated and the commonest was non-typhoidal Salmonella (NTS: n=18 or 50% of all isolates). The rate of bacteraemia was significantly higher in children with severe malarial anaemia without coma (11.2%) than in children with cerebral malaria without anaemia (3.2%) and this was due to the significant association of NTS bacteraemia with severe malarial anaemia (p<0.001). The overall case-fatality rate was 15% and was higher in children with bacteraemia (22%) but this difference was not significant. For the third objective, data were collected retrospectively of all children who received a blood transfusion in the paediatric department from March 1996 until May 1997 inclusive. A total of 1712 children received a blood transfusion. Of these, 243 (14.2%) had a blood culture taken for the investigation of fever following transfusion; a pathogen was grown from 60 (24.7%). NTS bacteraemia accounted for 76.3% of all bacteraemia cases. NTS bacteraemia is a common complication of severe malarial anaemia.
More Related Videos
09:04In Vivo Tracking of Edema Development and Microvascular Pathology in a Model of Experimental Cerebral Malaria Using Magnetic Resonance Imaging
Published on: June 8, 2017
08:23Phenotypic Analysis of Rodent Malaria Parasite Asexual and Sexual Blood Stages and Mosquito Stages
Published on: May 30, 2019
