scholarly journals Burden, clinical manifestation and outcome of severe malaria in children at a tertiary hospital in Northeast, Nigeria

2020 ◽  
Vol 7 (8) ◽  
pp. 1659
Author(s):  
Jalo I. ◽  
Isaac E. Warnow ◽  
Aliu R. ◽  
Hassan K. Shina
Keyword(s):  
Cerebral Malaria ◽  
Severe Malaria ◽  
Clinical Manifestation ◽  
Teaching Hospital ◽  
Tertiary Hospital ◽  
Severe Anaemia ◽  
Medical Emergency ◽  
Intervention Measures ◽  
Paediatric Unit ◽  
Criteria For Diagnosis

Background: Severe malaria is a life-threatening medical emergency and requires prompt and effective treatment to prevent death. The presentation of severe malaria varies depending on such factors as country, age, immunity, socioeconomic factors, drug resistance and type of intervention measures used. The aim of this study is to document the burden and forms of severe malaria in children in this region. Objective of this study was to determine the prevalence, clinical manifestation and outcome of children with severe malaria in Federal Teaching Hospital, GombeMethods: Case notes of patients admitted to the emergency Paediatric Unit and paediatric medical ward of Federal Teaching Hospital, Gombe with severe malaria from January 2014 to December 2018 (5years) were reviewed.  Information sought included age, gender, use of ITN, parents’ education and occupation, criteria for diagnosis, treatment and outcome.Results: A total of 2,808 children were admitted during the period of study, out of these 237 (8.4%) had severe malaria. There were 140 (59.1%) male and 97 (40.9%) female with M: F of 1.4:1. Majority 129 (54.4%) of patients were aged more than 5 years. The most frequent modes of presentation were multiple convulsions 124 (52.3%), cerebral malaria 97 (40.9%) and severe anaemia 61 (25.7%). Some 45 (19.0%) of the subjects presented with multiple diagnostic criteria. Multiple convulsions, cerebral malaria and severe anaemia were significantly related to likelihood of mortality.Conclusions: The prevalence of severe malaria is high and multiple convulsions, cerebral malaria and severe anaemia are significantly associated with risk of mortality.

scholarly journals Effect of health seeking behaviour of caregivers on severe malaria outcome in under-fives seen in a tertiary health institution in Nigeria

2020 ◽  
Vol 54 (3) ◽  
pp. 156-163
Author(s):  
Damian Nwaneri ◽  
Ayebo Sadoh
Keyword(s):  
Social Class ◽  
Cerebral Malaria ◽  
Severe Malaria ◽  
Cross Sectional Study ◽  
Severe Anaemia ◽  
World Health ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Cross Sectional ◽  
Health Institution

Background: Recognition of the symptoms and seeking prompt treatment in a health facility is a major means of reducing morbidity and prevention of mortality from severe malaria in under-fives.Objectives: To document the effect of health-seeking behaviour of caregivers and severe malaria outcome in underfives seen in a tertiary health institution in Nigeria.Design: A descriptive cross-sectional study carried out from July 2012 – June 2013. Data were obtained using a researcher-administered questionnaire.Subjects: Caregivers and children (6 – 59 months) who presented with features of severe malaria according to World Health Organization criteria.Results: Of the 120 caregivers mean [SD] age (31.4 [7.0] years) /child pairs (24 [14.7] months), 35 (29%) caregivers had appropriate health-seeking behaviour. The commonest place visited for initial healthcare before presentation was the patent medicine vendors by 87 (73%) caregivers. Seventy-seven per cent of caregivers who did not have appropriate health-seeking behaviour were from the lower family social class (p = 0.03). Caregivers whose children presented with severe anaemia were significantly more likely to have appropriate health-seeking behaviour (p = 0.00). The mortality rate of severe malaria was 15 per 1000; of which 94% were children whose caregivers did not have appropriate health-seeking behaviour. Age younger than 2 years (p = 0.02), cerebral malaria (p = 0.01) and jaundice (p = 0.03) significantly predicted mortality in the children irrespective of the caregivers’ health-seeking behaviour status.Conclusion: Less than a third of the caregivers had appropriate health-seeking behaviour for their under-fives with severe malaria, and the majority of these were from the lower family social class. Cerebral malaria and jaundice significantly predicted mortality in children with severe malaria irrespective of caregivers’ health-seeking behaviour status.Keywords: behaviour, caregivers, severe malaria, health-seeking, outcomeFunding: The study was self-sponsored by the authors

scholarly journals Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Boushab Mohamed Boushab ◽  
Mohamed Salem Ould Ahmedou Salem ◽  
Ali Ould Mohamed Salem Boukhary ◽  
Philippe Parola ◽  
Leonardo Basco
Keyword(s):  
Renal Failure ◽  
Respiratory Distress ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Clinical Features ◽  
Signs And Symptoms ◽  
Plasmodium Falciparum Malaria ◽  
Severe Anaemia ◽  
World Health ◽  
Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

scholarly journals Parenteral artemisinins are associated with reduced mortality and neurologic deficits and improved long-term behavioral outcomes in children with severe malaria

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Andrea L. Conroy ◽  
Robert O. Opoka ◽  
Paul Bangirana ◽  
Ruth Namazzi ◽  
Allen E. Okullo ◽  
...  
Keyword(s):  
Executive Function ◽  
Hospital Mortality ◽  
Cerebral Malaria ◽  
Severe Malaria ◽  
Behavioral Outcomes ◽  
Artemisinin Derivatives ◽  
Neurologic Deficits ◽  
Adjusted Scores

Abstract Background In 2011, the World Health Organization recommended injectable artesunate as the first-line therapy for severe malaria (SM) due to its superiority in reducing mortality compared to quinine. There are limited data on long-term clinical and neurobehavioral outcomes after artemisinin use for treatment of SM. Methods From 2008 to 2013, 502 Ugandan children with two common forms of SM, cerebral malaria and severe malarial anemia, were enrolled in a prospective observational study assessing long-term neurobehavioral and cognitive outcomes following SM. Children were evaluated a week after hospital discharge, and 6, 12, and 24 months of follow-up, and returned to hospital for any illness. In this study, we evaluated the impact of artemisinin derivatives on survival, post-discharge hospital readmission or death, and neurocognitive and behavioral outcomes over 2 years of follow-up. Results 346 children received quinine and 156 received parenteral artemisinin therapy (artemether or artesunate). After adjustment for disease severity, artemisinin derivatives were associated with a 78% reduction in in-hospital mortality (adjusted odds ratio, 0.22; 95% CI, 0.07–0.67). Among cerebral malaria survivors, children treated with artemisinin derivatives also had reduced neurologic deficits at discharge (quinine, 41.7%; artemisinin derivatives, 23.7%, p=0.007). Over a 2-year follow-up, artemisinin derivatives as compared to quinine were associated with better adjusted scores (negative scores better) in internalizing behavior and executive function in children irrespective of the age at severe malaria episode. After adjusting for multiple comparisons, artemisinin derivatives were associated with better adjusted scores in behavior and executive function in children <6 years of age at severe malaria exposure following adjustment for child age, sex, socioeconomic status, enrichment in the home environment, and the incidence of hospitalizations over follow-up. Children receiving artesunate had the greatest reduction in mortality and benefit in behavioral outcomes and had reduced inflammation at 1-month follow-up compared to children treated with quinine. Conclusions Treatment of severe malaria with artemisinin derivatives, particularly artesunate, results in reduced in-hospital mortality and neurologic deficits in children of all ages, reduced inflammation following recovery, and better long-term behavioral outcomes. These findings suggest artesunate has long-term beneficial effects in children surviving severe malaria.

scholarly journals Allelic diversity of merozoite surface protein genes (msp1 and msp2) and clinical manifestations of Plasmodium falciparum malaria cases in Aceh, Indonesia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kurnia Fitri Jamil ◽  
Nandha Rizki Pratama ◽  
Sylvia Sance Marantina ◽  
Harapan Harapan ◽  
Muhammad Riza Kurniawan ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Liver Function ◽  
Severe Malaria ◽  
Clinical Manifestation ◽  
Allelic Diversity ◽  
Surface Protein ◽  
Merozoite Surface Protein ◽  
Malaria Control Programme ◽  
Co Morbidity ◽  
Aceh Province

Abstract Background The malaria control programme in Indonesia has successfully brought down malaria incidence in many parts in Indonesia, including Aceh Province. Clinical manifestation of reported malaria cases in Aceh varied widely from asymptomatic, mild uncomplicated to severe and fatal complications. The present study aims to explore the allelic diversity of merozoite surface protein 1 gene (msp1) and msp2 among the Plasmodium falciparum isolates in Aceh Province and to determine their potential correlation with the severity of malaria clinical manifestation. Methods Screening of over 500 malaria cases admitted to the hospitals in 11 districts hospital within Aceh Province during 2013–2015, identified 90 cases of P. falciparum mono-infection without any co-morbidity. The subjects were clinically phenotyped and parasite DNA was extracted and polymerase chain reaction (PCR) amplified for the msp1 and msp2 allelic subfamilies. Results Analysis of clinical manifestation revealed that fever-chill is the most frequent symptom. Based on WHO criteria showed 19 cases were classified as severe and 71 as mild malaria. Analysis of msp1 gene revealed the presence of K1 allele subfamily in 34 subjects, MAD20 in 42 subjects, RO33 in 1 subject, and mixed allelic of K1 + MAD20 in 5 subjects, K1 + RO33 in 4 subjects, and MAD20 + RO33 in 4 subjects. Analysis of msp2 gene revealed 34 subjects carried the FC27 allelic subfamily, 37 subjects carried the 3D7 and 19 subjects carried the mixed FC27 + 3D7. Analysis of multiplicity of infection revealed that msp1 alleles is slightly higher than msp2 with the mean of MOI were 2.69 and 2.27, respectively. Statistical analysis to determine the association between each clinical manifestation and msp1 and msp2 alleles revealed that liver function abnormal value was associated with the msp2 mixed alleles (odds ratio (OR):0.13; 95%CI: 0.03–0.53). Mixed msp1 of K1 + RO33 was associated with severe malaria (OR: 28.50; 95%CI: 1.59–1532.30). Conclusion This study found a strong association between severe malaria in Aceh with subjects carrying the msp1 mixed alleles of K1 and RO33. The liver function abnormal value associated with the msp2 mixed allelic subfamilies. Further study in different geographic areas is recommended.

Features of an Intensive Care based Medical Emergency Team nurse training program in a University Teaching Hospital

2016 ◽  
Vol 29 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Michelle Topple ◽  
Brooke Ryan ◽  
Richard McKay ◽  
Damien Blythe ◽  
John Rogan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Training Program ◽  
Teaching Hospital ◽  
Medical Emergency Team ◽  
University Teaching ◽  
Medical Emergency ◽  
Nurse Training ◽  
Emergency Team

A review of presentations and outcome of severe malaria in a tertiary hospital in northwestern Nigeria

2021 ◽  
Vol 24 (3) ◽  
pp. 124
Author(s):  
Ibrahim Aliyu ◽  
HalimaUmar Ibrahim ◽  
Umma Idris ◽  
Helen Akhiwu ◽  
UmmaAbdulsalam Ibrahim ◽  
...  
Keyword(s):  
Severe Malaria ◽  
Tertiary Hospital

scholarly journals Cerebral malaria in children : an update

2015 ◽  
Vol 6 (2) ◽  
pp. 45-47
Author(s):  
Mirza Md Ziaul Islam ◽  
M Mizanur Rahman
Keyword(s):  
Cerebral Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Care Hospital ◽  
Medical College ◽  
Antimalarial Therapy ◽  
Neurological Presentation ◽  
Supportive Management ◽  
Prompt Diagnosis

Cerebral malaria (CM) is the most severe neurological presentation of acute falciparum malaria. It is a medical emergency, the hallmark of which is the presence of coma probably due to diffuse encephalopathy. A compromised microcirculation with sequestration of parasitized erythrocytes is central to the pathogenesis of cerebral malaria. The death is unacceptably high even with effective antimalarials in tertiary care hospital. The mainstay of treatment of cerebral malaria include prompt diagnosis and early institution of effective antimalarial therapy, recognition of complications, and appropriate supportive management in an ICU. Neurological sequlae are increasingly recognized, but further research on the pathogenesis of coma and neurological damage is required to develop other ancillary treatmentsNorthern International Medical College Journal Vol.6(2) 2015: 45-47

scholarly journals Symmetrical peripheral gangrene in a child following severe malaria with concomitant sepsis

2020 ◽  
Vol 47 (3) ◽  
pp. 280-284
Author(s):  
O.S. Katibi ◽  
B.S. Olorunshola ◽  
O.O. Akintade ◽  
O.S. Folayan
Keyword(s):  
Early Detection ◽  
Severe Malaria ◽  
Severe Anaemia ◽  
Clinical Syndrome ◽  
Ischemic Damage ◽  
Permanent Disability ◽  
Peripheral Gangrene ◽  
Distal Interphalangeal ◽  
Left And Right ◽  
High Index Of Suspicion

Symmetrical peripheral gangrene (SPG) is a welldocumented but rare clinical syndrome characterized by symmetrical distal ischemic damage  leading to gangrene of two or more sites in the absence of large vessel obstruction or vasculitis. The aetiological factors responsible for SPG are vast and it could follow many common diseases such as malaria. This is a report of a 9month old child who developed symmetric peripheral gangrene following severe malaria (severe anaemia) and sepsis. Gangrene involved the 2nd to the 5thdigits and 3rd and 4thdigits of the left and right hands and all the toes. Autoamputation of the affected digits followed several weeks after discharge and was limited to the distal  interphalangeal joints. There is the need for a high index of suspicion, early detection and prompt management of patients with disorders associated with SPG in order to limit the risk of permanent disability in otherwise treatable diseases. Key words: peripheral, gangrene, malaria, child

Sign in / Sign up

Export Citation Format

Share Document