1921
Volume 77, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

There are rare comparative studies of the clinical and laboratory features of severe and moderate malaria, including predictors of poor outcome, in rural and urban areas for regions of high malaria transmission. We therefore studied 2,235 children hospitalized for malaria in a rural (Lambaréné) and an urban (Libreville) area in Gabon between January 2001 and December 2002. From children screened, 33% and 48% were hospitalized for malaria in Libreville and Lambaréné, respectively ( < 0.001). Two malaria clinical groups were identified according to the World Health Organization 2000 classification of severe malaria. In both areas, severe malaria was characterized by a high proportion of severe anemia. The case fatality rate was 5-fold lower in Lambaréné than in Libreville (1% versus 5%; < 0.0001). In both sites, cerebral malaria associated with respiratory distress was the most important predictor of fatal malaria (odds ratio = 10.7, 95% confidence interval = 4.8–23.8 < 0.0001).

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2007-12-01
2017-11-17
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References

  1. Newton CRJC, Taylor TE, Whitten RO, 1998. Pathophysiology of fatal falciparum malaria in African children. Am J Trop Med Hyg 68 : 673–683.
  2. Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI, 2005. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 434 : 214–217.
  3. Remme JH, Binka F, Nabarro D, 2001. Toward a framework and indicators for monitoring Roll Back Malaria. Am J Trop Med Hyg 64 (Suppl 1– 2 ): 76–84.
  4. World Health Organization, 2000. Severe falciparum malaria. Trans R Soc Trop Med Hyg 94 (Suppl 1): S1–S90.
  5. Snow RW, Bastos de Azevedo I, Lowe BS, Kabiru EW, Nevill CG, Mwankusye S, Kassiga G, Marsh K, Teuscher T, 1994. Severe childhood malaria in two areas of markedly different falciparum transmission in East Africa. Acta Trop 57 : 289–300.
  6. Mockenhaupt FP, Ehrhardt S, Burkhardt J, Bosomtwe SY, Laryea S, Anemana SD, Otchwemah RN, Cramer JP, Dietz E, Gellert S, Bienzle U, 2004. Manifestation and outcome of severe malaria in children in Northern Ghana. Am J Trop Med Hyg 71 : 167–172.
  7. Richard-Lenoble D, Kombila M, Chandenier J, Gay F, Billiault X, Nguiri C, Martz M, Boyer F, Bauzou M, 1987. Malaria in Gabon. 2. Evaluation of the qualitative and quantitative prevalence of parasites in the total school and preschool population of the country. Bull Soc Pathol Exot Filiales 80 : 532–542.
  8. Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH, 1995. Malaria epidemiology in the Province of Moyen Ogouoe, Gabon. Trop Med Parasitol 46 : 77–82.
  9. Sylla EH, Kun JF, Kremsner PG, 2000. Mosquito distribution and entomological inoculation rates in three malaria-endemic areas in Gabon. Trans R Soc Trop Med Hyg 94 : 652–656.
  10. Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG, 2001. Comparison of methods for the rapid laboratory assessment of children with malaria. Am J Trop Med Hyg 65 : 599–602.
  11. 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, 1999. African children with malaria in area of intense Plasmodium falciparum transmission: features on admission to the hospital and risk factors for death. Am J Trop Med Hyg 61 : 431–438.
  12. Modiano D, Sirima BS, Sawadogo A, Sanou I, Konaté A, Pagnoni F, 1998. Severe malaria in Burkina Faso: influence of age and transmission level on clinical presentation. Am J Trop Med Hyg 59 : 539–542.
  13. Koko J, Duffilot D, Zima-Ebeyard AM, Duong TH, Gahouma D, Kombila M, 1997. Aspect du paludisme de l’enfant en milieu hospitalier gabonais. Med Trop 57 : 177–180.
  14. Assimadi JK, Gbadoé AD, Akakouma DY, Agbénowossi K, Lawson-Evi K, Gagibon A, Kassankognon Y, 1998. Paludisme sévère de l’enfant au Togo. Arch Pediatr 5 : 1310–1315.
  15. Marsh K, Forster D, Waruiru C, Mwangui I, Winstanley D, Marsh V, Newton CRJC, Winstanley P, Warn P, Pesu N, Pasvol G, Snow R, 1995. Indicators of life-threatening malaria in African children. N Engl J Med 332 : 399–404.
  16. Waller D, Krishna S, Crawley J, Miller K, Nosten F, Chapman D, ter Kuile FO, Craddock C, Berry C, Holloway PA, Brewster D, Greenwood BM, White NJ, 1995. Clinical features and outcome of severe malaria in Gambian children. Clin Infect Dis 21 : 577–587.
  17. Taylor TE, Borgstein A, Molyneux ME, 1993. Acid-base status in paediatrics Plasmodium falciparum malariaria. Q J Med 86 : 99–109.
  18. Krishna S, Walker DW, Ter Kuile F, Kwiakowski D, Crawley J, Craddock CFC, 1994. Lactic acidosis aqnd hypoglyceamia in children with severe malaria: pathophysiological and prognostic significance. Trans R Soc Trop Med Hyg 88 : 67–73.
  19. Agbenyega T, Angus B, Bedu-Addo G, Baffoe-Boni B, Griffin G, Vallance P, Krishna S, 1997. Plasma nitrogen oxides and blood lactate concentrations in Ghanaian children with malaria. Trans R Soc Trop Med Hyg 7 : 298–302.
  20. Faye O, Correa J, Camara B, Dieng T, Dieng Y, Gaye O, 1998. Létalité palustre en milieu pédiatrique dakaroise: étude des facteurs de risque. Med Trop 59 : 283–286.
  21. Keiser J, Utzinger J, Caldas De Castro M, Smith AT, Tanner M, Singer HB, 2004. Urbanization in Sub-Saharan Africa and implication for malaria control. Am J Trop Med Hyg 71 : 118–127.
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  • Received : 22 Mar 2006
  • Accepted : 27 Dec 2006

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