P Byakika-Kibwika1, G Ndeezi, M R Kamya. 1. Makerere University, School fo Medicine, Department of Medicine, Kampala, Uganda. pbyakika@gmail.com
Abstract
BACKGROUND: Severe malaria is responsible for the high load of malaria mortality. It is not clearly understood why some malaria episodes progress to severe malaria. OBJECTIVE: To determine factors associated with severe malaria in children aged 6 months to 5 years living in Kampala. METHODS: Over a 6-month period, 100 children with severe malaria were matched by age and place of residence with 100 children with non-severe malaria. We collected health care information from care takers. RESULTS: Mean duration of illness before getting antimalarial treatment was shorter for controls than cases (8 hours vs. 20 hours, p 0.015). Children with severe malaria were less likely to have been treated with sulphadoxine-pyrimethamine in the preceding 2 weeks (OR 0.2, 95% CI 0.04-0.85, p 0.016). Odds of severe malaria were higher in those who reported lack of protective measures (mosquito coils (OR = 20.63, 95% CI 1.5-283.3, p=0.02 and insecticide sprays OR 10.93, 95% CI 1.13-105.64, p=0.03), although few reported their use. CONCLUSIONS: Early anti-malarial treatment and use of barriers against mosquitoes prevent severe malaria in children. There is need to increase the use of barriers against mosquito bites and to scale up prompt treatment and community-based interventions to reduce the incidence of severe malaria in children.
BACKGROUND: Severe malaria is responsible for the high load of malaria mortality. It is not clearly understood why some malaria episodes progress to severe malaria. OBJECTIVE: To determine factors associated with severe malaria in children aged 6 months to 5 years living in Kampala. METHODS: Over a 6-month period, 100 children with severe malaria were matched by age and place of residence with 100 children with non-severe malaria. We collected health care information from care takers. RESULTS: Mean duration of illness before getting antimalarial treatment was shorter for controls than cases (8 hours vs. 20 hours, p 0.015). Children with severe malaria were less likely to have been treated with sulphadoxine-pyrimethamine in the preceding 2 weeks (OR 0.2, 95% CI 0.04-0.85, p 0.016). Odds of severe malaria were higher in those who reported lack of protective measures (mosquito coils (OR = 20.63, 95% CI 1.5-283.3, p=0.02 and insecticide sprays OR 10.93, 95% CI 1.13-105.64, p=0.03), although few reported their use. CONCLUSIONS: Early anti-malarial treatment and use of barriers against mosquitoes prevent severe malaria in children. There is need to increase the use of barriers against mosquito bites and to scale up prompt treatment and community-based interventions to reduce the incidence of severe malaria in children.
Entities:
Keywords:
Factors associated with severe malaria in children; Uganda; children; health care; severe malaria
Authors: D Luckner; B Lell; B Greve; L G Lehman; R J Schmidt-Ott; P Matousek; K Herbich; D Schmid; R Mba; P G Kremsner Journal: Trans R Soc Trop Med Hyg Date: 1998 Sep-Oct Impact factor: 2.184
Authors: O A Erunkulu; A V Hill; D P Kwiatkowski; J E Todd; J Iqbal; K Berzins; E M Riley; B M Greenwood Journal: Clin Exp Immunol Date: 1992-08 Impact factor: 4.330
Authors: R W Snow; N Peshu; D Forster; G Bomu; E Mitsanze; E Ngumbao; R Chisengwa; J R Schellenberg; R J Hayes; C I Newbold; K Marsh Journal: Trans R Soc Trop Med Hyg Date: 1998 Jul-Aug Impact factor: 2.184
Authors: Jesca Nsungwa-Sabiiti; Stefan Peterson; George Pariyo; Jasper Ogwal-Okeng; Max G Petzold; Goran Tomson Journal: Trans R Soc Trop Med Hyg Date: 2007-10-22 Impact factor: 2.184
Authors: Miriam K Laufer; Joep J G van Oosterhout; Philip C Thesing; Feston Thumba; Eduard E Zijlstra; Stephen M Graham; Terrie E Taylor; Christopher V Plowe Journal: J Infect Dis Date: 2006-02-08 Impact factor: 5.226
Authors: Sammy Wambua; Tabitha W Mwangi; Moses Kortok; Sophie M Uyoga; Alex W Macharia; Jedidah K Mwacharo; David J Weatherall; Robert W Snow; Kevin Marsh; Thomas N Williams Journal: PLoS Med Date: 2006-04-18 Impact factor: 11.069
Authors: Arthur Mpimbaza; Grace Ndeezi; Anne Katahoire; Philip J Rosenthal; Charles Karamagi Journal: Am J Trop Med Hyg Date: 2017-10-10 Impact factor: 2.345