Imported malaria in children: incidence and risk factors for severity

Dubos, François; Dauriac, Alice; Mansouf, Loubna El; Courouble, C.; Aurel, M.; Martinot, A.

doi:10.1016/j.diagmicrobio.2009.08.018

Cited by 15 publications

(10 citation statements)

References 15 publications

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“…The case fatality rate observed in our series is as high as those reported by the majority of African authors [4] [39]. The case fatality rate often varies between regions and countries; it is generally higher in African countries [4]; the inadequacy of intensive care facilities needed for the adequate management of these children is one of the reasons to that.…”

Section: The Lethalitysupporting

confidence: 57%

Blood Glucose Concentration Abnormalities in Children with Severe Malaria: Risk Factors and Outcome

Gildas¹,

Gaston²,

Laetitia³

et al. 2017

OJPed

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Background: The place of blood glucose abnormalities in severe malaria is poorly defined. The objective of the study was to determine the incidence of glycemic abnormalities and to identify the factors associated with their occurrence and death. Patients and Methods: A prospective study was conducted from January to October 2016 at the Teaching Hospital of Brazzaville. The blood glucose levels of all children hospitalized for severe malaria were measured for 3 days. The variables were compared in univariate and multivariate analysis. Results: A total of 158 children with an average age of 69.6 months ± 43.2 (ranges: 5 months and 15 years) were hospitalized for severe malaria. Moderate hyperglycemia was observed in 52.53% of children, severe hyperglycemia: 17.72%, moderate hypoglycemia: 15.19% and severe hypoglycemia: 2.53%. Children aged < 5 years (p = 0.03), females (p = 0.03), with disease duration before admission ≥ 7 days (p = 0.03) and referred from private hospitals (p = 0.04) had an increased risk of hypoglycemia. Age > 5 years was associated with hyperglycemia (p = 0.0006). The presence of hypoglycemia (blood glucose ≤ 3.3 mmol/L) on admission was associated with the risk of death (OR = 9.59, p = 0.02), no death occurred in children with hyperglycemia (p = 0.4) on admission. Conclusion: The incidence of blood glucose abnormalities is high in severe malaria. Hyperglycemia is more common than hypoglycemia, but only hypoglycemia is associated with an increased risk of death.

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Section: The Lethalitysupporting

confidence: 57%

Blood Glucose Concentration Abnormalities in Children with Severe Malaria: Risk Factors and Outcome

Gildas¹,

Gaston²,

Laetitia³

et al. 2017

OJPed

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show abstract

“…These studies have often focused on children less than five years of age, while this work has assessed a wider age range. Cases in children are of particular concern because of the increased potential for both rapid onset of severe disease, non-specific symptoms and delayed diagnosis in this group [7,28,47,48]. Children of a young age may be at increased risk due to intrinsically higher susceptibility.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for UK Plasmodium falciparum cases

Pinsent

Read

Griffin

et al. 2014

Malar J

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BackgroundAn increasing proportion of malaria cases diagnosed in UK residents with a history of travel to malaria endemic areas are due to Plasmodium falciparum.MethodsIn order to identify travellers at most risk of acquiring malaria a proportional hazards model was used to estimate the risk of acquiring malaria stratified by purpose of travel and age whilst adjusting for entomological inoculation rate (EIR) and duration of stay in endemic countries.ResultsTravellers visiting friends and relatives and business travellers were found to have significantly higher hazard of acquiring malaria (adjusted hazard ratio (HR) relative to that of holiday makers 7.4, 95% CI 6.4–8.5, p < 0. 0001 and HR 3.4, 95% CI 2.9-3.8, p < 0. 0001, respectively). All age-groups were at lower risk than children aged 0–15 years.ConclusionsThese estimates of the increased risk for business travellers and those visiting friends and relatives should be used to inform programmes to improve awareness of the risks of malaria when travelling.

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“…Diagnosis is delayed in one third of children with imported malaria [4, 12, 65]. The median time between onset of symptoms and diagnosis of malaria was recorded as 3–4 days [4, 65] but can extend up to 32 days [65].…”

Section: Imported Malaria In Childrenmentioning

confidence: 99%

Clinical practice

Maltha

Jacobs

2011

Eur J Pediatr

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The present paper reviews the diagnosis of imported malaria in children. Malaria is caused by a parasite called Plasmodium and occurs in over 100 countries worldwide. Children account for 10–15% of all patients with imported malaria and are at risk to develop severe and life-threatening complications especially when infected with Plasmodium falciparum. Case–fatality ratios vary between 0.2% and 0.4%. Children visiting friends and relatives in malaria endemic areas and immigrants and refugees account for the vast majority of cases. Symptoms are non-specific and delayed infections (more than 3 months after return from an endemic country) may occur. Microscopic analysis of the thick blood film is the cornerstone of laboratory diagnosis. For pragmatic reasons, EDTA-anticoagulated blood is accepted, provided that slides are prepared within 1 h after collection. Information about the Plasmodium species (in particular P. falciparum versus the non-falciparum species) and the parasite density is essential for patient management. Molecular methods in reference settings are an adjunct for species differentiation. Signals generated by automated hematology analyzers may trigger the diagnosis of malaria in non-suspected cases. Malaria rapid diagnostic tests are reliable in the diagnosis of P. falciparum but not for the detection of the non-falciparum species. They do not provide information about parasite density and should be used as an adjunct (and not a substitute) to microscopy. In case of persistent suspicion and negative microscopy results, repeat testing every 8–12 h for at least three consecutive samplings is recommended. A high index of suspicion and a close interaction with the laboratory may assure timely diagnosis of imported malaria.

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Imported malaria in children: incidence and risk factors for severity

Cited by 15 publications

References 15 publications

Blood Glucose Concentration Abnormalities in Children with Severe Malaria: Risk Factors and Outcome

Blood Glucose Concentration Abnormalities in Children with Severe Malaria: Risk Factors and Outcome

Risk factors for UK Plasmodium falciparum cases

Clinical practice

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