Life-Threatening Malaria in African Children: A Prospective Study in a Mesoendemic Urban Setting

BACKGROUND:The population exposed to malaria within African cities has steadily increased. However, comprehensive data on life-threatening malaria features and risk factors in children from urban areas with seasonal malaria transmission, such as in Bamako (Mali), are lacking. METHODS:Children admitt...

Full description

Saved in:

Bibliographic Details
Published in:	The Pediatric infectious disease journal Vol. 27; no. 2; pp. 130 - 135
Main Authors:	Ranque, Stéphane, Poudiougou, Belco, Traoré, Abdoulaye, Keita, Modibo, Oumar, Aboubacar A, Safeukui, Innocent, Marquet, Sandrine, Cabantous, Sandrine, Diakité, Mahamadou, Mintha, Daouda, Cissé, Mahamadou B, Keita, Marouf M, Dessein, Alain J, Doumbo, Ogobara K
Format:	Journal Article
Language:	English
Published:	Baltimore, MD Lippincott Williams & Wilkins, Inc 01-02-2008 Philadelphia, PA Lippincott Hagerstown, MD Lippincott, Williams & Wilkins
Subjects:	Adolescent Anemia - parasitology Anemias. Hemoglobinopathies Biological and medical sciences Child Child, Preschool Diseases of red blood cells Endemic Diseases Female Hematologic and hematopoietic diseases Human protozoal diseases Humans Infant Infant, Newborn Infectious diseases Life Sciences Malaria Malaria, Cerebral - epidemiology Malaria, Cerebral - mortality Male Mali - epidemiology Medical sciences Parasitic diseases Prospective Studies Protozoal diseases Risk Factors Seasons Urban Population Mali Africa Human Protozoa Pediatrics Apicomplexa Protozoal disease Urban environment Malaria Anemia Critically ill Hemopathy Parasitosis Infection Plasmodium falciparum Mali Pernicious attack severe malarial anemia cerebral malaria Child
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	BACKGROUND:The population exposed to malaria within African cities has steadily increased. However, comprehensive data on life-threatening malaria features and risk factors in children from urban areas with seasonal malaria transmission, such as in Bamako (Mali), are lacking. METHODS:Children admitted to the Gabriel Touré Hospital in Bamako with severe malarial anemia (SMA) and/or cerebral malaria (CM) were prospectively included in the study. Indicators of either SMA or CM were analyzed using logistic regression; and death hazard ratios (HRs) were estimated through survival analysis. RESULTS:The study included 455 children66% presented with CM, 34% with SMA, 3% with hypoglycemia (HG); 5% with dehydration; 17% with respiratory distress (RD); 25% with splenomegaly; and 92% with hepatomegaly. The children with CM were older than those with SMA. CM was more often associated with dehydration, HG, and RD, whereas SMA was more often associated with splenomegaly. The overall case fatality rate was 16%, and 94% of the children who died had CM. HG [HR2.37; 95% confidence interval (CI)1.04–5.39; P = 0.040], RD (HR4.23; 95% CI2.46–7.30; P < 10) and a deep coma with a Blantyre score of less than 3 (HR6.78, 95% CI2.43–18.91; P < 10), were all independent predictors of death. CONCLUSIONS:These findings delineate the patterns of severe malaria in children in a West African mesoendemic urban setting. They validate practicable prognostic indicators of life-threatening malaria for use in the limited facilities available in African health centers and provide a frame of reference for further research addressing life-threatening malaria in this setting.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0891-3668 1532-0987
DOI:	10.1097/INF.0b013e31815988ed