Determinants of outcome in febrile children admitted into the emergency rooms of two tertiary hospitals in Enugu Southeast Nigeria

Edelu, BenedictO; Igbokwe, ObianujuO.; Iloh, OgochukwuN.; Nduagubam, ObinnaC; Ndu, IkennaK

doi:10.4103/njm.njm_101_20

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…The most frequent clinical feature of severe malaria on admission was neurological disorders, particularly prostration and convulsion, followed by severe anaemia, hyperlactataemia and respiratory distress. Similar results were also observed by other authors [13,19,21,28,29,30]. Hypoglycaemia, haemoglobinuria and renal failure were less common in this study.…”

Section: Discussionsupporting

confidence: 93%

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Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville

Imboumy-Limoukou

Lendongo-Wombo

NGUIMBYANGUE-APANGOME

et al. 2023

Malar J

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Background Malaria is the most deadly parasitic disease and continues to claim more than a half million of deaths across the world each year, mainly those of under-fives children in sub-Saharan Africa. The aim of this study was to determine the epidemiological, clinical and laboratory features of patients with severe malaria at the Centre Hospitalier Régional Amissa Bongo (CHRAB), a referral hospital in Franceville. Methods It was an observational descriptive study conducted at CHRAB over 10 months. All admitted patients at the emergency ward of all ages presenting with positive test to falciparum malaria diagnosed by microscopy and rapid test with clinical signs of severe illness describe by World Health Organization were enrolled. Results During this study, 1065 patients were tested positive for malaria, of them 220 had severe malaria. Three quarters (75.0%) were less than 5 years of age. The mean time to consultation was 3.5 ± 1 days. The most frequent signs of severity on admission were dominated by neurological disorders 92.27% (prostration 58.6% and convulsion 24.1%), followed by severe anemia 72.7%, hyperlactatemia 54.6%, jaundice 25% and respiratory distress 21.82%.The other forms such as hypoglycemia, haemoglobinuria, renal failure were found in low proportions < 10%. Twenty-one patients died, coma (aOR = 15.54, CI 5.43–44.41, p < 0.01), hypoglycemia (aOR = 15.37, CI 2.17–65.3, p < 0.01), respiratory distress (aOR = 3.85, CI 1.53–9.73, p = 0.004) and abnormal bleeding (aOR = 16.42, CI 3.57–104.73, p = 0.003) were identified as independent predictors of a fatal outcome. Anemia was associated with decreased mortality. Conclusion Severe malaria remains a public health problem affecting mostly children under 5 years. Classification of malaria helps identify the most severely ill patients and aids early and appropriate management of the severe malaria cases.

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Section: Discussionsupporting

confidence: 93%

“…three quarters (75.0%) of population. This finding is in accordance with other studies, which states that children less than 5 years are most vulnerable to malaria [12,19,20,21,22]. Most of the participants (77.7%) used self-medication.…”

Section: Discussionsupporting

confidence: 93%

Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville

Imboumy-Limoukou

Lendongo-Wombo

NGUIMBYANGUE-APANGOME

et al. 2023

Malar J

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“…Malaria accounts for the highest number of hospitalizations and outpatient visits in Nigeria [1,3,4]. The most vulnerable Nigerians are under-ve children, who experience an average of 2-4 episodes per year and account for as much as 90% of national malaria mortality [5]. One of the major contributors to the global malaria burden especially in malaria endemic countries like Nigeria is rapid urbanization with the attendant challenges of overcrowding and environmental degradation, leading to growing concerns that malaria transmission may increase substantially in cities [2,6].…”

Section: Introductionmentioning

confidence: 99%

“…Appropriate and prompt health-seeking behaviour for malaria treatment is fundamental in the success of morbidity and mortality prevention strategies [5,7]. Health seeking behaviour, situated within the broader concept of health behaviour, can be de ned as, action or inaction undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of nding an appropriate remedy or care [8].…”

Section: Introductionmentioning

confidence: 99%

Are Urban residents seeking appropriate care for Malaria? Evidence from an exploratory qualitative study in two cities in Nigeria

Ogunwale,

Ajayi,

Bamgboye

et al. 2024

Preprint

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Background Unplanned and rapid urbanization within Nigerian cities with the attendant environmental consequences may hinder malaria elimination goal. Presently, there are limited qualitative studies on malaria case management, treatment and care-seeking patterns by settlement type in urban areas in Nigeria. This study, investigated the malaria-related health seeking behaviours among different settlement types in Ibadan and Kano metropolises, Nigeria. Methods This qualitative study involved conduct of Nine Focus Group Discussion (FGD) sessions among community members and 20 Key Informant interviews (KII) with health and community stakeholders in each of the two metropolises. The participants were purposively drawn from three settlement types – formal, informal and urban slum. Pretested FGD and KII were used to collect data. Data were subjected to thematic content analysis. Results Government-owned health facility especially Primary Health Care (PHC) facility was a major place identified as where many community members prefer to seek care for suspected malaria infection. Reasons adduced included proximity of facilities and services affordability. A common viewpoint was that most community members in informal and slum communities in both metropolises often patronize Proprietary Patent Medicine Vendors (PPMVs) or drug sellers as the first point for treatment of suspected malaria infection. Adduced reasons were poverty, ignorance and non-availability of 24 hours services in PHC facilities. High cost of hospital bills, poor attitude of health workers, long waiting time and cultural beliefs were identified as key factors influencing community members’ decision not to seek care for suspected malaria infection in the hospital. It was noted that the rich prefer to seek treatment in private hospitals, while the poor usually visit PHCs or resort to other options like buying drugs from PPMVs or use herbal drugs. Conclusion The preference of many community members in both metropolises for government-owned health facilities as well as the commoner practice of seeking care from patent medicine vendors and herbal drug sellers among informal settlements and slums dwellers calls for public health interventions. Specifically, the provision of free or affordable malaria care in health facilities; and training of community stakeholders and non-formal care providers on appropriate malaria care and referral to hospital are recommended.

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“…The complications include severe anaemia, cerebral malaria, hypoglycaemia, acute kidney injury, pulmonary oedema, haemoglobinuria, metabolic acidosis, algid malaria, and hyperparasitemia [9] [10] [11]. Severe anaemia and cerebral malaria are however the most common severe forms of malaria among children with cerebral malaria being responsible for the highest proportion of malaria mortality [12] [13].…”

Section: Introductionmentioning

confidence: 99%

Malaria Retinopathy among Under-Five Children with Severe and Uncomplicated Malaria in a Tertiary Health Institution in Southwest Nigeria: A Comparative Study

Olayinka,

Abiodun,

Jegede

et al. 2023

AID

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Introduction: Malaria retinopathy refers to retinal abnormalities unique to malaria resulting from prolonged parasitization by Plasmodium falciparum.Identifying these features and treating them promptly could prevent lethal complications of malaria. Therefore, this study was conducted to identify and compare retinal findings in severe and uncomplicated malaria. Methods: A cross-sectional study of 260 subjects was equally divided into two groups of severe and uncomplicated malaria. Direct ophthalmoscopy was done at recruitment for all subjects. Information on sociodemographics, physical examination, nutritional status, and retinal abnormalities were recorded. A p-value <5% was considered significant. Results: There were 141 (54.2%) males and 70 (26.9%) aged between 13 -24 months. Severe anaemia, multiple convulsions, prostration, and cerebral malaria were the predominant forms of severe malaria. Twenty-three (17.7%) subjects with severe malaria and none with uncomplicated malaria had retinopathy. Retinal whitening (17.7%), vessel changes (16.2%), and retinal haemorrhages (5.4%) were the major forms of retinopathy. Retinopathy occurred in 43.8% of those with cerebral malaria. Retinal whitening and vessel changes were significantly associated with multiple convulsions, cerebral malaria, and metabolic acidosis; retinal haemorrhage was associated with cerebral malaria and haemoglobinuria (p = 0.022) and vessel changes with hypoglycaemia (p = 0.037). Cerebral malaria was an independent predictor of retinal whitening (p = 0.004

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Determinants of outcome in febrile children admitted into the emergency rooms of two tertiary hospitals in Enugu Southeast Nigeria

Cited by 4 publications

References 13 publications

Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville

Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville

Are Urban residents seeking appropriate care for Malaria? Evidence from an exploratory qualitative study in two cities in Nigeria

Malaria Retinopathy among Under-Five Children with Severe and Uncomplicated Malaria in a Tertiary Health Institution in Southwest Nigeria: A Comparative Study

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