Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville
Abstract Background Malaria is the most deadly parasitic disease and continues to claim more than a half million of deaths across the world each year, mainly those of under-fives children in sub-Saharan Africa. The aim of this study was to determine the epidemiological, clinical and laboratory featu...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-023-04512-7 |
| _version_ | 1797865555464552448 |
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| author | Roméo Karl Imboumy-Limoukou Judicael Boris Lendongo-Wombo Andhra Fecilia Nguimbyangue-Apangome Jean-Claude Biteghe Bi Essone Franck Mounioko Lydie Sandrine Oyegue-Libagui Brice Edgar Ngoungou Jean-Bernard Lekana-Douki |
| author_facet | Roméo Karl Imboumy-Limoukou Judicael Boris Lendongo-Wombo Andhra Fecilia Nguimbyangue-Apangome Jean-Claude Biteghe Bi Essone Franck Mounioko Lydie Sandrine Oyegue-Libagui Brice Edgar Ngoungou Jean-Bernard Lekana-Douki |
| author_sort | Roméo Karl Imboumy-Limoukou |
| collection | DOAJ |
| description | Abstract Background Malaria is the most deadly parasitic disease and continues to claim more than a half million of deaths across the world each year, mainly those of under-fives children in sub-Saharan Africa. The aim of this study was to determine the epidemiological, clinical and laboratory features of patients with severe malaria at the Centre Hospitalier Régional Amissa Bongo (CHRAB), a referral hospital in Franceville. Methods It was an observational descriptive study conducted at CHRAB over 10 months. All admitted patients at the emergency ward of all ages presenting with positive test to falciparum malaria diagnosed by microscopy and rapid test with clinical signs of severe illness describe by World Health Organization were enrolled. Results During this study, 1065 patients were tested positive for malaria, of them 220 had severe malaria. Three quarters (75.0%) were less than 5 years of age. The mean time to consultation was 3.5 ± 1 days. The most frequent signs of severity on admission were dominated by neurological disorders 92.27% (prostration 58.6% and convulsion 24.1%), followed by severe anemia 72.7%, hyperlactatemia 54.6%, jaundice 25% and respiratory distress 21.82%.The other forms such as hypoglycemia, haemoglobinuria, renal failure were found in low proportions < 10%. Twenty-one patients died, coma (aOR = 15.54, CI 5.43–44.41, p < 0.01), hypoglycemia (aOR = 15.37, CI 2.17–65.3, p < 0.01), respiratory distress (aOR = 3.85, CI 1.53–9.73, p = 0.004) and abnormal bleeding (aOR = 16.42, CI 3.57–104.73, p = 0.003) were identified as independent predictors of a fatal outcome. Anemia was associated with decreased mortality. Conclusion Severe malaria remains a public health problem affecting mostly children under 5 years. Classification of malaria helps identify the most severely ill patients and aids early and appropriate management of the severe malaria cases. |
| first_indexed | 2024-04-09T23:10:00Z |
| format | Article |
| id | doaj.art-ab66f0a5b2564f9ea99398f38795590b |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-09T23:10:00Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-ab66f0a5b2564f9ea99398f38795590b2023-03-22T10:28:59ZengBMCMalaria Journal1475-28752023-03-012211810.1186/s12936-023-04512-7Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of FrancevilleRoméo Karl Imboumy-Limoukou0Judicael Boris Lendongo-Wombo1Andhra Fecilia Nguimbyangue-Apangome2Jean-Claude Biteghe Bi Essone3Franck Mounioko4Lydie Sandrine Oyegue-Libagui5Brice Edgar Ngoungou6Jean-Bernard Lekana-Douki7Unité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevUnité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevUnité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevUnité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevUnité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevUnité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevDépartement d’épidémiologie, Biostatistiques Et Informatique Médicale, Université Des Sciences de La Santé (USS)Unité Ecologie Evolution et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de FrancevillevAbstract Background Malaria is the most deadly parasitic disease and continues to claim more than a half million of deaths across the world each year, mainly those of under-fives children in sub-Saharan Africa. The aim of this study was to determine the epidemiological, clinical and laboratory features of patients with severe malaria at the Centre Hospitalier Régional Amissa Bongo (CHRAB), a referral hospital in Franceville. Methods It was an observational descriptive study conducted at CHRAB over 10 months. All admitted patients at the emergency ward of all ages presenting with positive test to falciparum malaria diagnosed by microscopy and rapid test with clinical signs of severe illness describe by World Health Organization were enrolled. Results During this study, 1065 patients were tested positive for malaria, of them 220 had severe malaria. Three quarters (75.0%) were less than 5 years of age. The mean time to consultation was 3.5 ± 1 days. The most frequent signs of severity on admission were dominated by neurological disorders 92.27% (prostration 58.6% and convulsion 24.1%), followed by severe anemia 72.7%, hyperlactatemia 54.6%, jaundice 25% and respiratory distress 21.82%.The other forms such as hypoglycemia, haemoglobinuria, renal failure were found in low proportions < 10%. Twenty-one patients died, coma (aOR = 15.54, CI 5.43–44.41, p < 0.01), hypoglycemia (aOR = 15.37, CI 2.17–65.3, p < 0.01), respiratory distress (aOR = 3.85, CI 1.53–9.73, p = 0.004) and abnormal bleeding (aOR = 16.42, CI 3.57–104.73, p = 0.003) were identified as independent predictors of a fatal outcome. Anemia was associated with decreased mortality. Conclusion Severe malaria remains a public health problem affecting mostly children under 5 years. Classification of malaria helps identify the most severely ill patients and aids early and appropriate management of the severe malaria cases.https://doi.org/10.1186/s12936-023-04512-7Severe malariaFalciparumEmergency wardGabon |
| spellingShingle | Roméo Karl Imboumy-Limoukou Judicael Boris Lendongo-Wombo Andhra Fecilia Nguimbyangue-Apangome Jean-Claude Biteghe Bi Essone Franck Mounioko Lydie Sandrine Oyegue-Libagui Brice Edgar Ngoungou Jean-Bernard Lekana-Douki Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville Malaria Journal Severe malaria Falciparum Emergency ward Gabon |
| title | Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville |
| title_full | Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville |
| title_fullStr | Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville |
| title_full_unstemmed | Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville |
| title_short | Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville |
| title_sort | severe malaria in gabon epidemiological clinical and laboratory features in amissa bongo hospital of franceville |
| topic | Severe malaria Falciparum Emergency ward Gabon |
| url | https://doi.org/10.1186/s12936-023-04512-7 |
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