[Severe malaria in children at the pediatric service of the Befelatanana Hospital Center at Antananarivo (Madagascar) in 1996-1998].

The definition of severe malaria is no longer limited to cerebral malaria, but it is as well extended to other clinical forms of the disease. The authors reported the epidemiological and clinical survey and evaluative aspects of severe malaria in Antananarivo. This retrospective study included 48 children less than 15 years old, hospitalized at the paediatric unit Debré of the Centre Hospitalier Universitaire de Befelatanana (Antananarivo) for severe malaria as defined by world Health Organization (WHO) criteria. The hospitalization frequency was 0.87%. Higher frequency was noticed for the children less than 5 years old, the sex-ratio was 1.4/1. The cerebral complications as seen in many African countries were the most frequent clinical form. The death rate was 14.58% and the proportional mortality was 1.07%, 2.1% of the patients had sequel. The improvement of severe malaria prognosis was not only on better equipment in intensive care wards, but also on improved and early diagnosis and management.