Severe malaria in children in Yemen: two site observational study

被引:36
作者
Al-Taiar, Abdullah
Jaffar, Shabbar
Assabri, Ali
Al-Habori, Molham
Azazy, Ahmed
A-Mahdi, Nagiba
Ameen, Khaled
Greenwood, Brian M.
Whitty, Christopher J. M.
机构
[1] Sanaa Univ, Fac Med & Hlth Sci, Sanaa 13078, Yemen
[2] Univ London London Sch Hyg & Trop Med, Dept Infect & Trop Dis, London WC1E 7HT, England
[3] Yemeni Swedish Hosp, Taizi, Yemen
来源
BMJ-BRITISH MEDICAL JOURNAL | 2006年 / 333卷 / 7573期
基金
英国医学研究理事会;
关键词
D O I
10.1136/bmj.38959.368819.BE
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives To assess the burden of malaria on health services, describe the clinical presentation of severe malaria in children, and identify factors associated with mortality by means of a prospective observational study Setting Two public hospitals in Taiz (mountain hinterland) and Hodeidah (coastal plain), Yemen. Participants Children aged 6 months to 10 years. Results Of 12 301 paediatric admissions, 2071 (17%) were for suspected severe malaria. The proportion of such admissions varied according to the season (from 1% to 40%). Falciparum malaria was confirmed in 1332 children; 808 had severe disease as defined by the World Health Organization. Main presentations were respiratory distress (322/808, 40%), severe anaemia (291/800,37%), and cerebral malaria (60/808, 8%). Twenty two of 26 children who died had a neurological presentation. No deaths occurred in children with severe anaemia but no other signs of severity. In multivariate analysis, a Blantyre coma score <= 2. history of fits, female sex, and hyperlactataemia predicted mortality; severe anaemia, respiratory distress, and hyperparasitaemia were not significant predictors of mortality. Conclusions Severe malaria puts a high burden on health services in Yemen. Although presentation is similar to African series, some important differences exist. Case fatality is higher in girls.
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收藏
页码:827 / 830A
页数:5
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