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.
引用
收藏
页码:827 / 830A
页数:5
相关论文
共 20 条
[11]   The prognostic value of measures of acid/base balance in pediatric falciparum malaria, compared with other clinical and laboratory parameters [J].
Newton, CRJC ;
Valim, C ;
Krishna, S ;
Wypij, D ;
Olola, C ;
Agbenyega, T ;
Taylor, TE .
CLINICAL INFECTIOUS DISEASES, 2005, 41 (07) :948-957
[12]   OVERLAP IN THE CLINICAL-FEATURES OF PNEUMONIA AND MALARIA IN AFRICAN CHILDREN [J].
ODEMPSEY, TJD ;
MCARDLE, TF ;
LAURENCE, BE ;
LAMONT, AC ;
TODD, JE ;
GREENWOOD, BM .
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 1993, 87 (06) :662-665
[13]   African children with malaria in an area of intense Plasmodium falciparum transmission:: Features on admission to the hospital and risk factors for death [J].
Schellenberg, D ;
Menendez, C ;
Kahigwa, E ;
Font, F ;
Galindo, C ;
Acosta, C ;
Schellenberg, JA ;
Aponte, JJ ;
Kimario, J ;
Urassa, H ;
Mshinda, H ;
Tanner, M ;
Alonso, P .
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 1999, 61 (03) :431-438
[14]   IN-HOSPITAL MORBIDITY AND MORTALITY DUE TO MALARIA-ASSOCIATED SEVERE ANEMIA IN 2 AREAS OF MALAWI WITH DIFFERENT PATTERNS OF MALARIA INFECTION [J].
SLUTSKER, L ;
TAYLOR, TE ;
WIRIMA, JJ ;
STEKETEE, RW .
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 1994, 88 (05) :548-551
[15]   SEVERE CHILDHOOD MALARIA IN 2 AREAS OF MARKEDLY DIFFERENT FALCIPARUM TRANSMISSION IN EAST-AFRICA [J].
SNOW, RW ;
DEAZEVEDO, IB ;
LOWE, BS ;
KABIRU, EW ;
NEVILL, CG ;
MWANKUSYE, S ;
KASSIGA, G ;
MARSH, B ;
TEUSCHER, T .
ACTA TROPICA, 1994, 57 (04) :289-300
[16]   Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa [J].
Snow, RW ;
Omumbo, JA ;
Lowe, B ;
Molyneux, CS ;
Obiero, JO ;
Palmer, A ;
Weber, MW ;
Pinder, M ;
Nahlen, B ;
Obonyo, C ;
Newbold, C ;
Gupta, S ;
Marsh, K .
LANCET, 1997, 349 (9066) :1650-1654
[17]   Standardized data collection for multi-center clinical studies of severe malaria in African children: establishing the SMAC network [J].
Taylor, Terrie ;
Olola, Christopher ;
Valim, Clarissa ;
Agbenyega, Tsiri ;
Kremsner, Peter ;
Krishna, Sanjeev ;
Kwiatkowski, Dominic ;
Newton, Charles ;
Missinou, Michel ;
Pinder, Margaret ;
Wypij, David .
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 2006, 100 (07) :615-622
[18]   Independent indicators of outcome in severe paediatric malaria: maternal education, acidotic breathing and convulsions on admission [J].
Varandas, L ;
Julien, M ;
Van Lerberghe, W ;
Goncalves, L ;
Ferrinho, P .
ANNALS OF TROPICAL PAEDIATRICS, 2000, 20 (04) :265-271
[19]  
World Health Organization - WHO, 2005, WORLD MAL REP 2005
[20]  
2006, LANCET, V367, P959