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

Abstract

Background: Severe malaria is a major public health challenge and a leading cause of morbidity and mortality in tropical countries. Severe malaria is defined as life-threatening manifestation in the presence of asexual forms of Plasmodium falciparum in the peripheral blood; it is also caused by Plasmodium vivax and Plasmodium knowlesi. Materials and Methods: This was a 2-year point retrospective review of cases of severe malaria seen in the Emergency Pediatric Unit of Federal Medical Centre, Birnin Kudu, Jigawa state, between August and November, for each of the years 2016 and 2017. Results: Two hundred and fifty-seven cases of severe malaria were recorded during the study period: 106 (41.2%) cases in 2016 and 151 (58.8%) cases in 2017. There were 156 (60.7%) males and 101 (39.3%) females with a male-to-female ratio of 1.5:1. Their ages ranged from 0.3 to 14.0 years, with a mean age of 4.4 ± 3.6 years. Prostration was the most common form of severe disease; this was followed by multiple convulsion and severe malarial anemia. The year 2017 recorded more cases of severe malaria in all the age groups and majority of the cases were 5 years and below; and these observations were statistically significant for those with hypoglycemia (χ2 = 9.834, df = 2, P = 0.007) and hyperparasitemia (χ2 = 6.226, df = 2, P = 0.044). Majority of the subjects fitted with more than one form of severe malaria; most had two to three combinations. This observation was also statistically significant (χ2 = 12.950, df = 6, P = 0.042). Conclusion: Severe malaria remains a huge strain on the health system; prostration, multiple convulsion, and severe malaria anemia are the most common forms.