Blood Glucose Concentration Abnormalities in Children with Severe Malaria: Risk Factors and Outcome

Abstract

Background: The place of blood glucose abnormalities in severe malaria is poorly defined. The objective of the study was to determine the incidence of glycemic abnormalities and to identify the factors associated with their occurrence and death. Patients and Methods: A prospective study was conducted from January to October 2016 at the Teaching Hospital of Brazzaville. The blood glucose levels of all children hospitalized for severe malaria were measured for 3 days. The variables were compared in univariate and multivariate analysis. Results: A total of 158 children with an average age of 69.6 months ± 43.2 (ranges: 5 months and 15 years) were hospitalized for severe malaria. Moderate hyperglycemia was observed in 52.53% of children, severe hyperglycemia: 17.72%, moderate hypoglycemia: 15.19% and severe hypoglycemia: 2.53%. Children aged < 5 years (p = 0.03), females (p = 0.03), with disease duration before admission ≥ 7 days (p = 0.03) and referred from private hospitals (p = 0.04) had an increased risk of hypoglycemia. Age > 5 years was associated with hyperglycemia (p = 0.0006). The presence of hypoglycemia (blood glucose ≤ 3.3 mmol/L) on admission was associated with the risk of death (OR = 9.59, p = 0.02), no death occurred in children with hyperglycemia (p = 0.4) on admission. Conclusion: The incidence of blood glucose abnormalities is high in severe malaria. Hyperglycemia is more common than hypoglycemia, but only hypoglycemia is associated with an increased risk of death.