Clinical manifestations and outcomes of severe malaria among children admitted to Rungwe and Kyela district hospitals in south-western Tanzania

  • Akili K. Kalinga National Institute for Medical Research-Tanzania
  • Mary Mayige Tukuyu Research Centre, Tukuyu
  • Gibson Kagaruki Tukuyu Research Centre, Tukuyu
  • Amani Shao Tukuyu Research Centre, Tukuyu
  • Brighton Mwakyusa Tukuyu Research Centre
  • Frank Jacob Rungwe District Council, Tukuyu
  • Charles Mwesiga Kyela District Council, Kyela
Keywords: malaria, children, hospital, clinical, symptoms, outcome, Tanzania

Abstract

Malaria remains as an important public health and a major cause of childhood death and paediatric hospital admission in sub-Saharan Africa. This prospective hospital based cross sectional study was conducted from April 2007 to April 2008. The main objective was to assess clinical manifestations and outcomes of severe malaria in children admitted to district hospital in Rungwe and Kyela in south-western Tanzania. A total of 1371 children were selected as screening group of which 409 (29.8%) were tested positive for malaria. Mean age of the children was 2.7 (95%CI= 2.5, 2.8) years and the majority (86%) were under five years of age. The proportion of children severe malaria in Rungwe was significantly higher than that of Kyela by 21.3% (P=0.002). The common symptoms of severe malaria during admission were convulsions (50.9%) compensated shock (30.6%), prostration (29.1%) and symptomatic severe anaemia (14.9%). The case fatality rate (CFR) was 4.6% and the cure rate (CR) was 95.4%. Children with suspected severe acidosis and symptomatic severe anemia were 4.8 (95%CI=1.6, 14.6) and 5.5 (95%CI 1.1, 28.2), respectively, more likely to die compared to those without these symptoms. The proportion of deaths among children presenting ≥5 symptoms was 32.1% higher than among those presenting one symptom (OR =0.50, 95%CI 0.125-2.000; P=0.000). Convulsions and compensated shock were the leading symptoms at admission. Suspected severe acidosis and symptomatic severe anemia were the predictors of mortality for children. In order to reduce mortality among admitted children with severe malaria there is a need for health providers to deploy strategic management of fatal prognostic factors. In conclusion, convulsion and compensated shock were the leading symptoms among children at admission and that suspected severe acidosis and symptomatic severe anemia were the predictors of mortality. It is therefore important to emphasis early diagnosis and prompt treatment of severe cases of malaria to minimize mortality among children.

Author Biography

Akili K. Kalinga, National Institute for Medical Research-Tanzania
Research Scientist
Published
2011-12-30
How to Cite
KalingaA. K., MayigeM., KagarukiG., ShaoA., MwakyusaB., JacobF., & MwesigaC. (2011). Clinical manifestations and outcomes of severe malaria among children admitted to Rungwe and Kyela district hospitals in south-western Tanzania. Tanzania Journal of Health Research, 14(1). https://doi.org/10.4314/thrb.v14i1.2
Section
Articles

Journal Identifiers


eISSN: 1821-9241
print ISSN: 1821-6404