Characterization and Treatment of Severe Malaria in Hospitalized Children at a Ghanaian District Hospital

Gyapong, Reginald; Duwiejua, M.; Bio, F. Y.; Woode, E.; Ansah, Charles; Owusu-Daaku, F. T.; Buabeng, Kwame Ohene

doi:10.2174/1874315300902010039

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…However, the low CFR observed in our study is in agreement with studies carried out in Uganda (Idro & Aloyo, 2004) and in Gabon (Issifou et al, 2007). Interestingly, in a study done among children admitted to Kumasi Hospital in Ghana, none of the children with severe malaria died (Gyapong et al, 2009). The low CFR in our study is likely be attributed to early treatment seeking behaviour among children care seekers and good management of severe malaria.…”

Section: Discussionsupporting

confidence: 92%

Clinical manifestations and outcomes of severe malaria among children admitted to Rungwe and Kyela district hospitals in south-western Tanzania

Kalinga

Mayige²,

Kagaruki³

et al. 2012

Tanzania J Hlth Res

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Malaria remains as an important public health and a major cause of childhood death and paediatric hospital admission in sub-Saharan Africa. This prospective hospital based cross sectional study was conducted from April 2007 to April 2008. The main objective was to assess clinical manifestations and outcomes of severe malaria in children admitted to district hospital in Rungwe and Kyela in south-western Tanzania. A total of 1371 children were selected as screening group of which 409 (29.8%) were tested positive for malaria. Mean age of the children was 2.7 (95%CI= 2.5, 2.8) years and the majority (86%) were under five years of age. The proportion of children severe malaria in Rungwe was significantly higher than that of Kyela by 21.3% (P=0.002). The common symptoms of severe malaria during admission were convulsions (50.9%) compensated shock (30.6%), prostration (29.1%) and symptomatic severe anaemia (14.9%). The case fatality rate (CFR) was 4.6% and the cure rate (CR) was 95.4%. Children with suspected severe acidosis and symptomatic severe anemia were 4.8 (95%CI=1.6, 14.6) and 5.5 (95%CI 1.1, 28.2), respectively, more likely to die compared to those without these symptoms. The proportion of deaths among children presenting ≥5 symptoms was 32.1% higher than among those presenting one symptom (OR =0.50, 95%CI 0.125-2.000; P=0.000). Convulsions and compensated shock were the leading symptoms at admission. Suspected severe acidosis and symptomatic severe anemia were the predictors of mortality for children. In order to reduce mortality among admitted children with severe malaria there is a need for health providers to deploy strategic management of fatal prognostic factors. In conclusion, convulsion and compensated shock were the leading symptoms among children at admission and that suspected severe acidosis and symptomatic severe anemia were the predictors of mortality. It is therefore important to emphasis early diagnosis and prompt treatment of severe cases of malaria to minimize mortality among children. ____________________________________________________________________________

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Section: Discussionsupporting

confidence: 92%

Clinical manifestations and outcomes of severe malaria among children admitted to Rungwe and Kyela district hospitals in south-western Tanzania

Kalinga

Mayige²,

Kagaruki³

et al. 2012

Tanzania J Hlth Res

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“…The results also showed significant numbers (n = 81/150, 54 %) of severe P. falciparum infections and indicate a fair index of the prevalence of the disease among children with malaria attending the hospital (Agyapong et al 2009). Two observation merit attention.…”

Section: Discussionmentioning

confidence: 76%

Effect of Plasmodium falciparum malaria parasites on haematological parameters in Ghanaian children

et al. 2014

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Malaria is hyper-endemic in Ghana. Haematological alterations in the disease pathology may offer complimentary criteria to improve clinical and microscopy diagnosis. Our primary outcome was to evaluate haematological parameters in children with Plasmodium falciparum infections and report their predictive risk and diagnostic performance for malaria infections in Ghana. Haematological data, including thin and thick blood films were examined for children less than 12 years of age in a multicenter-based active case finding approach. Haematological changes were common in P. falciparum infected children and more pronounced in severe malaria cases. More so, a unit increase in parasiteamia increased the odds for severe malaria infection by 93 % [OR, 95 % CI: 1.93 (1.28-2.91); P value = 0.02]. In multivariate regression, low haemoglobin was a significant haematological change in predicting P. falciparum infections [OR,); P value = 0.001]. Low haemoglobin levels \11 g/dl was the most reliable indicator for P. falciparum infections [with a sensitivity of (64 %), specificity (71 %), positive predictive value (83 %) and likelihood ratio (2.2)]-even when evaluated in combination with leucocytosis, lymphocytopaenia and high neutrophil counts [7,500 lL. In malaria endemic settings, low haemoglobin concentration (\11 g/dl) in children with febrile illness should prompt a more diligent search for the malarial parasite to limit the misuse and abuse of anti-malarial drugs.

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Characterization and Treatment of Severe Malaria in Hospitalized Children at a Ghanaian District Hospital

Cited by 2 publications

References 15 publications

Clinical manifestations and outcomes of severe malaria among children admitted to Rungwe and Kyela district hospitals in south-western Tanzania

Clinical manifestations and outcomes of severe malaria among children admitted to Rungwe and Kyela district hospitals in south-western Tanzania

Effect of Plasmodium falciparum malaria parasites on haematological parameters in Ghanaian children

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