Abstract
The clinical spectrum of severe malaria has not been described in Bushenyi, hence; this study was carried out to document the prevalence, major clinical features, contributing factors and immediate outcome of this number one killer disease of under-five children, at Kampala International University Teaching Hospital (KIUTH). This is a pilot study. Study design was retrospective; carried out in the records department of KIUTH; the study population were files of children, 5 years of age and below who attended KIUTH between August and October 2009, sample size was 100 using systematic random sampling. Ethical clearance and permission were obtained. Data was collected using checklist, entered into Epi-Info version 3.2 and analysed with SPSS 16 statistical software. Prevalence of complicated malaria was 29.8%. Male: female ratio was 1.33:1. Peak age was 3years, 78% of the children had no wasting and 62% slept under treated bed nets. The three most common presentations were febrile multiple convulsions (69%), hyperparasitemia (67%) and circulatory shock (59%), prolonged coma was the least presentation (30%). The infants most commonly present with severe anaemia (60%), while the older ones manifest usually with febrile multiple convulsions (76.9%). Mortality rate was 14%, higher in the malnourished (27.3%), boys (19.3%), age 5year bracket (23.1%), with hypoglycaemia (18.8%), respiratory distress (17.9%) and multiple febrile convulsions (17.4%). The prevalence and mortality from severe malaria was high. The most common presentations were multiple febrile convulsions, hyperparasitaemia and circulatory shock. Immediate outcome was significantly affected by the nutritional status. A larger study will be done in future for a more complete picture of this problem.
Highlights
Malaria is endemic in 95% of Uganda
The significance between the variables was determined using Chi-square and p-value less than 0.05 was considered significant. This was a review of 100 cases of severe malaria in children, 5years of age and below, who attended Kampala International University Teaching Hospital (KIUTH) over a period of 3months, between August and October 2009
Survival rate was highest amongst the infants (100%), Fig. 7. This retrospective study was undertaken to determine the prevalence, clinical pattern and outcome among under-five children diagnosed with severe malaria over a period of 3 months (August to October 2009) in Kampala International University Teaching Hospital, Uganda
Summary
Malaria is endemic in 95% of Uganda. The remaining 5%, areas in the highlands of the southwest and east, are epidemic-prone. (Talisuna, 1999; Idro, 2001) According to a recent report from the World Health Organization, Uganda has the world’s highest malaria incidence, with a rate of 478 cases per 1000 population per year (Idro, 2001; Namboze, 1997; National Malaria Control Policy Formulation Task Force, 1997).In Uganda, malaria accounts for the highest disease burden in the country and is the leading cause of underfive morbidity and mortality (Idro, 2001). (Talisuna, 1999; Idro, 2001) According to a recent report from the World Health Organization, Uganda has the world’s highest malaria incidence, with a rate of 478 cases per 1000 population per year (Idro, 2001; Namboze, 1997; National Malaria Control Policy Formulation Task Force, 1997). Malaria is responsible for 25 to 40% of all outpatient visits, 2025% of all hospital admissions and about 14% of all hospital deaths ((Idro, 2001; Namboze, 1997; National Malaria Control Policy Formulation Task Force, 1997; Ministry of Health, 2000). In 2009, according to WHO statistics, only 10% of our under-fives sleep under mosquito nets (Ministry of Health, 2008)
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