The Determinants of Fatal Outcomes during Severe Malaria in Children at the HKM University Teaching Hospital of Cotonou-Benin

摘要

>Introduction: style="font-size:10pt;"> style="font-size:12px;">Malaria particularly affects children in sub-Saharan African style="font-size:10pt;"> style="font-size:12px;"> countries. This study aimed to investigate the factors associated with death in cases of severe childhood malaria to better understand the determinants of death in these children. style="font-size:12px;">Patients and Methods: style="font-size:10pt;"> style="font-size:10pt;"> style="font-size:12px;">This cohort, descriptive and analytical style="font-size:12px;">study was conducted from April 1 to August 15, 2015, at the CNHU-HKM style="font-size:12px;"> pediatric clinic in Cotonou. Recruitment was exhaustive for all patients under 15 style="font-size:12px;">years of age who were admitted for severe malaria, as confirmed by thick style="font-size:12px;"> smear microscopy. style="font-size:12px;">Results: style="font-size:10pt;"> style="font-size:12px;">Among the 1774 admitted patients, 449 had severe malaria style="font-size:10pt;"> style="font-size:10pt;"> style="font-size:12px;">caused by style="font-size:12px;">Plasmodium falciparum style="font-size:12px;"> ( style="font-size:12px;">i.e. style="font-size:12px;">, a hospital frequency of 25.31%). The age group most affected consisted of children younger than 60 months of age (73%); female predominance was noted. The lethality rate of malaria was 13.1% (n = 59). The factors associated with death were coma (p = 0.032), poor style="font-size:12px;">convulsive status epilepticus (p = 0.08) and bacterial co-infection style="font-size:10pt;"> style="font-size:12px;">by gram style="font-size:10pt;"> style="font-size:12px;"> nega style="font-size:12px;">tive bacteria (p = 0.021) style="font-size:10pt;"> style="font-size:12px;">with respectively correlations coefficient of 0.003, 3.940 style="font-size:12px;">and style="font-size:10pt;"> style="font-size:12px;"> 2.424. style="font-size:12px;">Conclusion: style="font-size:12px;">Reduction of the malaria mortality rates in Benin hos style="font-size:10pt;"> style="font-size:12px;">pit style="font-size:12px;">als will depend on appropriate management of poor prognostic factors, suc style="font-size:12px;">h as coma, bacterial co-infection and convulsive illness.