[The malaria epidemic in Antananarivo from 1983 to 1994 as seen through the Pediatric Service A in the Befelatanana General Hospital].

We report the symptoms of children affected by an epidemy of a serious form of malaria which raged in Tananarive from 1983 to 1994. These data are based on the hospital registers for the "Debré" room of the Pediatric Service "A" in the Befelatanana Hospital, and underline a few points as follows. In terms of morbidity, the epidemy started in 1984, reached a peak in 1988 (26.7% of the admitted), and started to spread in 1992. Boys and girls were equally affected, with the majority of children being 5 years old or more (51 to 58% of the cases). Most of the ill were coming from the suburbs (66.5%) in addition to those from the center (33.5%) of the city of Tananarive. At the peak of the epidemy, nearly half of the children had serious paludism (48.9%). Plasmodium falciparum was the causative parasite in 98.3% of the cases. Mortality did not seem to be influenced by the sex, age or residence of the children, but the two factors always encountered were malnutrition and late hospitalization. Treatment based on the use of quinine enabled the elimination of mortality by neuropaludism in 1991 to 1992. However, in 1993 and 1994, we are witnessing a reappearance of mortality apparently linked to the decline of the nutritional state of the ill.