Severe malaria in Gabon: epidemiological, clinical and laboratory features in Amissa Bongo Hospital of Franceville

Abstract

Background Malaria is the most deadly parasitic disease and continues to claim more than a half million of deaths across the world each year, mainly those of under-fives children in sub-Saharan Africa. The aim of this study was to determine the epidemiological, clinical and laboratory features of patients with severe malaria at the Centre Hospitalier Régional Amissa Bongo (CHRAB), a referral hospital in Franceville. Methods It was an observational descriptive study conducted at CHRAB over 10 months. All admitted patients at the emergency ward of all ages presenting with positive test to falciparum malaria diagnosed by microscopy and rapid test with clinical signs of severe illness describe by World Health Organization were enrolled. Results During this study, 1065 patients were tested positive for malaria, of them 220 had severe malaria. Three quarters (75.0%) were less than 5 years of age. The mean time to consultation was 3.5 ± 1 days. The most frequent signs of severity on admission were dominated by neurological disorders 92.27% (prostration 58.6% and convulsion 24.1%), followed by severe anemia 72.7%, hyperlactatemia 54.6%, jaundice 25% and respiratory distress 21.82%.The other forms such as hypoglycemia, haemoglobinuria, renal failure were found in low proportions < 10%. Twenty-one patients died, coma (aOR = 15.54, CI 5.43–44.41, p < 0.01), hypoglycemia (aOR = 15.37, CI 2.17–65.3, p < 0.01), respiratory distress (aOR = 3.85, CI 1.53–9.73, p = 0.004) and abnormal bleeding (aOR = 16.42, CI 3.57–104.73, p = 0.003) were identified as independent predictors of a fatal outcome. Anemia was associated with decreased mortality. Conclusion Severe malaria remains a public health problem affecting mostly children under 5 years. Classification of malaria helps identify the most severely ill patients and aids early and appropriate management of the severe malaria cases.

Severe malaria in adolescents in the post-COVID-19 era, at the university hospital of Libreville

“…1,15 The survey by Imboumy-Limoukou et al conducted during the same period as ours in the southeastern region of Gabon, shows that neurological disorders are present in 92.27% of children hospitalized for severe malaria. 16 They were present in 43% of cases in the study by Wombo et al and 41% in the study by Bouyou et al 10 Neurological disorders, therefore, appear to be the most frequent clinical signs of severe malaria of all classes. The abundance of neurological troubles could find an explanation in the fact that neurological disorders are linked to both the pathophysiology of cerebral malaria on the one hand and anaemia on the other, both leading to cerebral hypoxia.…”

Effects of Daily Zinc Alone or in Combination with Other Nutrient Supplements on the Risk of Malaria Parasitaemia: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

“…The disease is primarily transmitted to humans through the bites of infected female Anopheles mosquitoes [1]. Several different species of Plasmodium parasites can cause malaria in humans, with Plasmodium falciparum being the deadliest and most prevalent [2,3]. However, other species, such as P. vivax, P. ovale, P. malariae, and P. knowlesi, can also cause malaria, although cases involving their infection tend to be less severe [2].…”

Detection of Plasmodium falciparum in Saliva and Stool Samples from Children Living in Franceville, a Highly Endemic Region of Gabon

“…In Franceville (in southeast Gabon), malaria is the main cause of paediatric consultations and hospitalisation, with an average prevalence of 18% in symptomatic patients. In patients with a Plasmodium infection, severe malaria represents 20% of P. falciparum infections [7,8].…”