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[Severe malaria in children in Togo]
J K Assimadi1, A D Gbadoé, D Y Atakouma
1Service de pédiatrie, CHU-Tokoin, Lomé.
Insights
Severe malaria in children in Togo is often characterized by severe anemia and cerebral complications. Early management of hypoglycemia and improved intensive care can significantly improve outcomes for severe malaria patients.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of malaria
- Clinical tropical medicine
Background:
- The definition of severe malaria has expanded beyond cerebral malaria to include other clinical manifestations.
- This study investigates the epidemiological, clinical, and prognostic factors of severe malaria in Togo.
Purpose of the Study:
- To analyze the epidemiological, clinical, and evolutive aspects of severe malaria in children in Togo.
- To identify key factors influencing the prognosis of severe malaria.
Main Methods:
- A retrospective study of 549 children (0-15 years) hospitalized for severe malaria between 1994-1995.
- Data collected included clinical presentation, complications, and outcomes based on World Health Organization (WHO) criteria.
Main Results:
- Severe malaria accounted for 7.44% of pediatric hospitalizations, with the highest incidence in children aged 1-5 years.
- Severe anemia and cerebral complications were the most frequent clinical forms. The mortality rate was 18.94%, and 2.73% experienced neurological sequelae.
- Hypoglycemia was observed in 11.6% of cases and was significantly associated with a poor prognosis.
Conclusions:
- Improving the prognosis of severe malaria in Africa requires enhanced intensive care unit equipment.
- Early and effective management of hypoglycemia is crucial for improving severe malaria outcomes.
Background:
The definition of severe malaria is no longer limited to cerebral malaria, but is as well extended to other clinical forms of the disease. This work analyses epidemiological, clinical and evolutive aspects of severe malaria in Togo.
Patients And Methods:
This study included 549 children, aged from 0 to 15 years, hospitalized in 1994-5 in the pediatric department of the Lome-Tokoin University Teaching Hospital for severe malaria as defined by World Health Organization (WHO) criteria.
Results:
The hospitalization frequency was 7.44%; the maximum frequency was from 1 to 5 years of age, but 6.56% of patients were more than 10 years old. The most frequent clinical form was that of severe anemia, followed by cerebral complications, as seen in many African countries. The death rate was 18.94% and the proportional mortality was 8.21%; 2.73% of the patients had neurological sequelae (behaviour disturbances in five cases, aphasia in four, hemiplegia in three, mumbling in one, oculomotor paralysis in one, and cerebellar ataxia in one). Hypoglycemia was fairly frequent (11.6%) and was associated with a poor prognosis.
Conclusion:
It is possible to improve severe malaria prognosis in Africa by insisting not only on better equipment in intensive care wards, but also on improved and early management of hypoglycemia.