Abstract
Introduction: Malaria management has been a source of concern for health systems since the advent of the Covid-19 pandemic. Objective: To assess the impact of the Covid-19 pandemic on severe childhood malaria in Brazzaville. Material and Method: A quasi-experimental intervention/non-intervention study was carried out between March and October 2020 in the pediatric departments of the Brazzaville University Hospital. Children aged three months to 15 years hospitalized were the target population. Two groups were formed: the “intervention” group, that of children hospitalized between March and October 2020 and the “control” group that of those hospitalized between January and August 2015. The study variables were epidemiological, clinical, biological and therapeutic. Chi-square and T-Student tests were used. The impact of the intervention was assessed by the absolute risk difference. Results: Of 1392 children hospitalized, 199 (14.6%) had severe malaria with an average age of 6.94 years. These were children under 5 years old n = 95 (47.7%) of low socioeconomic level n = 145 (72.9%) seen on average after 4.6 +/? 2.4 days. Repeated convulsions (56.8%) and anemia (20.1%) were the main reasons for hospitalization. These were isolated forms (n = 146; 73.4%) of which n = 84 (42.2%) neurological and n = 62 (31.2%) anemic. The lethality was 13.1%. Delayed consultation, fever, repeated convulsions, pallor, respiratory distress, sickle cell anemia, thrombocytopenia and hypoglycemia are associated with death. The risk difference for signs of severity between the two periods was 16.6 for repeated convulsions; 14.3 for severe anemia. The relative risk between the two studies was 1.8. Conclusion: The increase in morbidity and mortality in severe malaria since the beginning of the Covid-19 pandemic encourages the maintenance of the balance between the management of the Covid-19 pandemic and that of other worrying health problems.
Highlights
Malaria management has been a source of concern for health systems since the advent of the Covid-19 pandemic
Fever, repeated convulsions, pallor, respiratory distress, sickle cell anemia, thrombocytopenia and hypoglycemia are associated with death
Our study aimed to assess the impact of the covid-19 pandemic on severe childhood malaria at the University Hospital of Brazzaville and the objectives: determine the frequency of severe malaria; describe the clinical, para-clinical, therapeutic and evolutionary aspects; identify the factors associated with the death of a child hospitalized for severe malaria during the Covid-19 pandemic period and report the indicators of its impact on severe childhood malaria in Brazzaville
Summary
Malaria management has been a source of concern for health systems since the advent of the Covid-19 pandemic. Objective: To assess the impact of the Covid-19 pandemic on severe childhood malaria in Brazzaville. Results: Of 1392 children hospitalized, 199 (14.6%) had severe malaria with an average age of 6.94 years. While African populations continue to pay the heavy price for severe malaria [5], the Covid-19 pandemic risks are hampering the efforts of health systems around the world [11]. Our study aimed to assess the impact of the covid-19 pandemic on severe childhood malaria at the University Hospital of Brazzaville and the objectives: determine the frequency of severe malaria; describe the clinical, para-clinical, therapeutic and evolutionary aspects; identify the factors associated with the death of a child hospitalized for severe malaria during the Covid-19 pandemic period and report the indicators of its impact on severe childhood malaria in Brazzaville
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