Severe malaria in children and adolescents in Southeast Gabon

Abstract

Introduction Malaria remains a significant public health problem in sub-Saharan Africa. Child mortality due to severe malaria remains high in developing countries despite improvements in malaria management and a better understanding of its pathophysiology. To address the lack of epidemiological studies on severe malaria in Gabon, this study describes the epidemiological aspects of severe malaria in rural, semi-rural, and urban areas of southeast Gabon. Methods Demographic, clinical, and laboratory data for children and adolescents aged 0–18 years were collected in 2019 from hospital records at three health facilities in southeastern Gabon. The patients included in the study were positive for P falciparum malaria diagnosed by microscopy with at least one of the malaria severity criteria. Results Severe malaria accounted for 18.8% (667/3552) of malaria cases. Children aged 0–5 years accounted for 71.8% (479/667) of all severe malaria cases. Adolescents over 15 years of age were the least affected by severe malaria with 4.2% (28/667). Across the study, severe anemia (49.0%, 327/667), convulsions (43.0%, 287/667), respiratory distress (5.1%, 34/667), and altered consciousness (4.8%, 32/667) were the most frequent clinical signs of severe malaria in children. Franceville was the locality most affected by severe malaria with 49.2% (328/667), followed by Koulamoutou with 42.0% (280/667) and Lastourville with 8.8% (59/667). Convulsions (50.6%, 166/328) and coma (6.1%, 20/328) were more frequent in children living in urban areas. In contrast, severe anemia (56.7%, 186/339) and jaundice (6.8%, 23/339) were more common in children living in semi-rural areas. Conclusion Severe malaria is more prevalent in urban areas in regions with a high malaria transmission intensity. However, in this study, the epidemiological characteristics of severe malaria were similar in the three settings (urban, rural, and semi-rural areas) despite different levels of urbanization. Nevertheless, the various signs of severity were more frequent in Franceville, an urban area. Children under 5 years of age remain the most vulnerable age group.

Severe Malaria in Adolescents in the Post-COVID-19 Era, at the University Hospital of Libreville

“…The proportions of the other primary severe forms are shown in Figure 3. [9]. Neurological disorders, therefore, appear to be the most frequent clinical signs of severe malaria of all classes.…”

Therapeutic efficacy and safety of artesunate + amodiaquine and artemether + lumefantrine in treating uncomplicated Plasmodium falciparum malaria in children on the rainy south-east coast of Madagascar

“…In 2016, malaria parasite prevalence by microscopy among children 6–59 months of age was 9.0% in the zones encompassing Kianjavato, Antsenavolo and Vohitromby [ 12 ]. Patients with any clinical signs of severe malaria [ 16 , 30 ] or any serious concomitant disease, such as cardiovascular disease, were excluded. Pregnant or breast-feeding women were also excluded, and a urine pregnancy test was performed in all women of child-bearing age.…”

Assessment of environmental and spatial factors influencing the establishment of Anopheles gambiae larval habitats in the malaria endemic province of Woleu-Ntem, northern Gabon

“…In Gabon, a country highly affected by malaria [ 23 – 25 ], particularly in the province of Woleu-Ntem [ 4 ], research on malaria parasite transmission, particularly the identification of Anopheles larval habitats, remains scant. In this context, entomological studies using remote sensing to identify factors favoring Anopheles mosquito presence could significantly advance targeted malaria control by eliminating surface waters conducive to mosquito proliferation.…”