High postdischarge morbidity in Ugandan children with severe malarial anemia or cerebral malaria
Document Type
Article
Department
Paediatrics and Child Health (East Africa)
Abstract
Background: Cerebral malaria (CM) and severe malarial anemia (SMA) account for a substantial proportion of malaria-related deaths in sub-Saharan Africa. However, postdischarge morbidity in children with CM or SMA has not been well established.
Methods: Children 18 months to 12 years of age, enrolled on admission to Mulago National Referral Hospital in Kampala, Uganda (CM, n = 162; SMA, n = 138), and healthy children recruited from the community (CC) (n = 133) were followed up for 6 months. The incidences of hospitalizations and outpatient clinic visits for illness during the follow-up period were compared between children with CM or SMA and the CC.
Results: After adjustment for age, sex, and nutritional status, children with SMA had a higher incidence rate ratio (IRR) than CC for hospitalization (95% confidence interval [CI], 20.81 [2.48–174.68]), hospitalization with malaria (17.29 [95% CI, 2.02–148.35]), and clinic visits for any illness (95% CI, 2.35 [1.22–4.51]). Adjusted IRRs for children with CM were also increased for all measures compared with those for CC, but they achieved statistical significance only for clinic visits for any illness (2.24 [95% CI, 1.20–4.15]). In both groups, the primary reason for the clinic visits and hospitalizations was malaria.
Conclusions: In the 6 months after initial hospitalization, children with SMA have an increased risk of repeated hospitalization, and children with CM or SMA have an increased risk of outpatient illness. Malaria is the main cause of inpatient and outpatient morbidity. Malaria prophylaxis has the potential to decrease postdischarge morbidity rates in children with SMA or CM.
Publication (Name of Journal)
Pediatric Infectious Diseases Society
DOI
https://doi.org/10.1093/jpids/piw060
Recommended Citation
Opoka, R.,
Hamre, K.,
Brand, N.,
Bangirana, P.,
Idro, R.,
John, C.
(2017). High postdischarge morbidity in Ugandan children with severe malarial anemia or cerebral malaria. Pediatric Infectious Diseases Society, 6(3), 41-48.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/500
Comments
This work was published before the author joined Aga Khan University.