Severe malaria among children in Gambella, western Ethiopia

Abstract

Abstract Background: Most of the malarial morbidity and mortality occur in children and pregnant women. Annually 1-2 million children die of malaria in Africa. The information on the epidemiology of severe malaria among children in Ethiopia is scanty. Objective: To assess the pattern of clinical features of severe malaria and their association with mortality. Methods: A prospective study was conducted in the pediatric ward of Gambella hospital between June 1998 and November 1999. There were a total of 127 children with severe malaria. Demographic, clinical and laboratory data were collected using structured questionnaires. Results: The mean age of the children was 36.7 months. The mortality rate was 22% and most deaths occurred in the first 24 hour (60.7%). The most common findings were anaemia (hematocrit <33%), nasal flaring, grunting, chest indrawing, diarrhea and convulsion in decreasing order. Anaemia was significantly linked to mortality when any signs of respiratory distress were present. A child with any sign of respiratory distress, with or without auscultatory chest finding, is at higher risk of dying. No association between coma and mortality was found. Impaired consciousness, with or without convulsion, was significantly associated with mortality. Conclusion: A child with severe signs of respiratory distress and/or impaired consciousness is at increased risk of death. Hence they need prompt and early detection with effective management. [Ethiop. J. Health Dev. 2002;16(1):61-70]