Clinical Profile and Outcome of Paediatric Severe Malaria in a North-Eastern Nigerian Tertiary Hospital

Abstract

Aims: The following cross-sectional study is performed to describe the clinical manifestations and outcome of severe malaria among children admitted into the Federal Medical Centre Azare, Nigeria. Study Design: The study was a cross-sectional study. Place and Duration of Study: The study was conducted at the Department of Paediatrics, Federal Medical Centre, Azare, Bauchi state, Nigeria from 1st August to 31st October 2013. Methodology: Children aged 6 months to 12 years diagnosed with severe malaria were consecutively recruited from the Emergency Paediatric Unit. The information obtained included age, sex, weight, presenting complaints and associated symptoms. Elicited clinical signs, as well as the outcome were also documented. The data was analysed using SPSS version 16.0. Results: Ninety- eight patients diagnosed with severe malaria were recruited into the study. There were 57 (58.2%) boys and 41 (41.8%) girls giving a male to female ratio of 1.4: 1. The mean age of the patients was 4.2± 2.8 years, with a median and modal age of 3 years. Ninety patients (91.8%) survived and were discharged home while 8 died, giving a case fatality rate of 8.2%. Cough (P = .04), breathlessness (P = .001), reduction in urine output (P = .003), loss of consciousness (P = .01) and abdominal swelling (P = .03) were significantly more common in children aged 3 years and below. There were also statistically significant relationships between age and nutritional status (P =.03), hepatomegaly (P =.02), coma (P˂.001) as well as severe anaemia (P =.03). Six (6.1%) and 3 (3.1%) of the 8 deaths had convulsions and severe anaemia respectively. Nevertheless, binary logistics regression analysis showed that coma (P =.03) and dehydration (P =.02) were the most likely to predict death. Conclusion: Prompt identification and management of fluid and electrolyte deficits may significantly reduce mortality in children with severe malaria managed at the Federal Medical Centre, Azare, Nigeria.