| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The symptoms of severe malaria and their contribution to mortality were assessed in 290 children in northern Ghana. Common symptoms were severe anemia (55%), prostration (33%), respiratory distress (23%), convulsions (20%), and impaired consciousness (19%). Age influenced this pattern. The fatality rate was 11.2%. In multivariate analysis, circulatory collapse, impaired consciousness, hypoglycemia, and malnutrition independently predicted death. Children with severe malaria by the current World Health Organization (WHO) classification, but not by the previous one (1990), showed relatively mild clinical manifestations and a low case fatality rate (3.2%). In hospitalized children with severe malaria in northern Ghana, severe anemia is the leading manifestation, but itself does not contribute to mortality. In this region, malnutrition and circulatory collapse were important predictors of fatal malaria. The current WHO criteria serve well in identifying life-threatening disease, but also include rather mild cases that may complicate the allocation of immediate care in settings with limited resources.
Received September 3, 2003. Accepted for publication February 9, 2004.
Acknowledgments: We thank the nursing staff at the Department of Paediatrics, Tamale Teaching Hospital for their help, and Mark A. James for critically reading of the manuscript. This study is part of the Northern Region Malaria Project and forms part of the doctoral thesis of Jana Burkhardt.
Financial support: This study was supported by Charité grant 2003–676.
Authors’ addresses: Frank P. Mockenhaupt, Jana Burkhardt, Jakob P. Cramer, and Ulrich Bienzle, Institute of Tropical Medicine, Spandauer Damm 130, 14050 Berlin, Germany, Telephone: 49-30-3011-6815, Fax: 49-30-3011-6888, E-mail: frank.mockenhaupt{at}charite.de. Stephan Ehrhardt, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany, Telephone: 49-40-4281-8373, Fax: 49-40-4281-8400. Samuel Y. Bosomtwe, Stephen Laryea, and Sabine Gellert, Tamale Teaching Hospital, PO Box 16, Tamale, Ghana. Sylvester D. Anemana, Regional Health Administration, Ministry of Health, Takoradi, Ghana, Telephone/Fax: 233-31-46462. Rowland N. Otchwemah, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana, Telephone/Fax: 233-71-22046. Ekkehart Dietz, Institute for International Health, Fabeckstrasse 60-62, Haus 562, 14195 Berlin, Germany, Telephone: 49-30-8445-1293, Fax: 49-30-8445-1280.
This article has been cited by other articles:
|
|
 |
|
  A. S. Winkler, G. Salmhofer, R. Helbok, F. Kalokola, W. Matuja, and E. Schmutzhard In-Hospital Risk Estimation in Children with Malaria--Early Predictors of Morbidity and Mortality J Trop Pediatr, June 1, 2008; 54(3): 184 - 191. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Issifou, E. Kendjo, M. A. Missinou, P. B. Matsiegui, A. Dzeing-Ella, F. A. Dissanami, M. Kombila, S. Krishna, and P. G. Kremsner Differences in Presentation of Severe Malaria in Urban and Rural Gabon Am J Trop Med Hyg, December 1, 2007; 77(6): 1015 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. P. Mockenhaupt, K. Reither, P. Zanger, F. Roepcke, I. Danquah, E. Saad, P. Ziniel, S. Y. Dzisi, M. Frempong, P. Agana-Nsiire, et al. Intermittent Preventive Treatment in Infants as a Means of Malaria Control: a Randomized, Double-Blind, Placebo-Controlled Trial in Northern Ghana Antimicrob. Agents Chemother., September 1, 2007; 51(9): 3273 - 3281. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Tripathy, S. Parida, L. Das, D. P. Mishra, D. Tripathy, M. C. Das, H. Chen, J. H. Maguire, and P. Panigrahi Clinical Manifestations and Predictors of Severe Malaria in Indian Children Pediatrics, September 1, 2007; 120(3): e454 - e460. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Al-Taiar, S. Jaffar, A. Assabri, M. Al-Habori, A. Azazy, N. Al-Mahdi, K. Ameen, B. M Greenwood, and C. J M Whitty Severe malaria in children in Yemen: two site observational study BMJ, October 21, 2006; 333(7573): 827. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. P. Mockenhaupt, J. P. Cramer, L. Hamann, M. S. Stegemann, J. Eckert, N.-R. Oh, R. N. Otchwemah, E. Dietz, S. Ehrhardt, N. W. J. Schroder, et al. Toll-like receptor (TLR) polymorphisms in African children: Common TLR-4 variants predispose to severe malaria PNAS, January 3, 2006; 103(1): 177 - 182. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. IDRO, E. BITARAKWATE, S. TUMWESIGIRE, and C. C. JOHN CLINICAL MANIFESTATIONS OF SEVERE MALARIA IN THE HIGHLANDS OF SOUTHWESTERN UGANDA Am J Trop Med Hyg, May 1, 2005; 72(5): 561 - 567. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
