Severe Falciparum Malaria: Prevalence, Comorbidities and Outcome in children in Port Harcourt, Nigeria

International Journal of Medical Science
© 2019 by SSRG - IJMS Journal
Volume 6 Issue 10
Year of Publication : 2019
Authors : Nsirimobu Ichendu Paul, Lucy Eberechukwu Yaguo-Ide
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Nsirimobu Ichendu Paul, Lucy Eberechukwu Yaguo-Ide, "Severe Falciparum Malaria: Prevalence, Comorbidities and Outcome in children in Port Harcourt, Nigeria," SSRG International Journal of Medical Science, vol. 6,  no. 10, pp. 5-13, 2019. Crossref, https://doi.org/10.14445/23939117/IJMS-V6I10P102

Abstract:

Severe malaria is a paediatric emergency of public health importance globally but is worse in Sub-Saharan Africa including Nigeria where it claims millions of under-fives lives annually, if not promptly treated.
The study aimed to find the prevalence of severe malaria, its comorbidities and outcome of treatment among children presenting into the children emergency ward (CHEW) of the University of Port Harcourt Teaching Hospital (UPTH).
This was a retrospective study carried out in January 2014 to December 2018 at the CHEW of the University of Port Harcourt teaching Hospital, Port Harcourt. The admission register in the CHEW and the patients case notes were used to obtain the total number of admissions and to identify the children who presented with a diagnosis of severe malaria. Using a structured questionnaire, their biodata, occupation and educational level of parents, month of admission, type of severe malaria, duration of hospital stay, comorbidities and outcome of treatment were obtained. socioeconomic class was determined using Oyedeji classification. Obtained data was analysed using SPSS version 20 and relationship between variables was tested using chi square and a P value of <0.05 was regarded as statistically significant. Result is presented in prose, frequencies, tables and charts. There were 503 children with severe malaria, giving a prevalence of 8.6%. 282 males and 221 females with a M:F ratio of 1.28: 1. Their ages ranged from 2 months to 16 years, with a mean age of 4 years ± 1.5 years. 57.1% of the children were between 1-5years and 65% of them were from the lower socioeconomic class. Severe malaria anaemia (SMA) 289 (57.5%) was the commonest form of severe malaria seen in this study, but for Disseminated intravascular coagulation all the various manifestations of severe malaria were more common in children from the lower socioeconomic class and this difference was statistically significant p=0.0001. Sepsis was the most occurring comorbidity seen in 40% of cases. Case fatality rate in this study was 10.7%, this was not significantly affected by sex or age p=0.6147, p=0.8958 respectively Severe falciparum malaria is high in children in Port Harcourt Nigeria. The case fatality is high with SMA
presenting more commonly in children between one to five years and sepsis as the commonest comorbidity
Every under-five child coming to any health facility in Nigeria, should be screened for malaria. Malaria diagnostic tools should be made available to all primary health facilities and pharmacy shops where these patients first present to, before coming to the hospital. There should be improvement in our blood transfusion services to reduce the long hours spent waiting for blood. Every child diagnosed for severe malaria should also be screened for sepsis.

Keywords:

Severe Falciparum malaria, prevalence, comorbidities, outcome.

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