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

Abstract

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. Method It was an observational descriptive study conducted at CHRAB over ten months. All admitted patients at the emergency ward of all ages presenting with positive test to falciparum malaria diagnose 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 younger than 5 years. 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% in particular 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 = 0.96-0.99, 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 five years. Classification of malaria helps identify the most severely ill patients and aids early and appropriate management of the severe malaria cases.

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

“…Factors associated with severe adolescent vs. infant malaria. Limoukou, et al conducted during the same period as ours in the southeastern region of Gabon, shows that neurological disorders are present in 92.27% of children hospitalized for severe malaria[15]. They were present in 43% of cases in the study byLedongo Wombo, et al and 41% in the study by Bouyou, et al…”

Exploring the Infectious Drug Target Glutathione S-Transferase in Plasmodium falciparum with the Inhibitory Potential of Azadirachta indica Phytocompounds

“…Several species of the Plasmodium parasite are responsible for malaria, but the most lethal and widespread form of the disease is caused by Plasmodium falciparum [1]. The bite of a female Anopheles mosquito carrying the malaria parasite is the most common way humans contract the disease.…”