ArticleMalaria journal2023
Unusual clinical spectra of childhood severe malaria during malaria epidemic in eastern Uganda: a prospective study.
Article in Malaria journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Characterization of Malaria Outbreak in Marsabit County, Kenya, March 2024.The American journal of tropical medicine and hygiene · 2025Article
- Severe malaria readmissions in Northern Uganda: a cross-sectional study.Malaria journal · 2025Article
- Epidemiology, clinical spectrum, and outcomes of severe malaria in Eastern Uganda: a prospective study.Malaria journal · 2025Article
- The Association Between Malaria Parasite Geometrical Mean and Clinical Spectrum of Severe Disease in a High-Transmission Setting in Eastern Uganda: A Cross-Sectional Study.Journal of parasitology research · 2025Article
- Acetylsalicylic acid and dihydroartemisinin combined therapy on experimental malaria-associated acute lung injury: analysis of lung function and the inflammatory process.Malaria journal · 2024Article
- Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative.Malaria journal · 2024Article
- Patient socio-demographics and clinical factors associated with malaria mortality: a case control study in the northern region of Ghana.Malaria journal · 2024Article
- Non-falciparum malaria infections in Uganda, does it matter? A review of the published literature.Malaria journal · 2024Review
- Dramatic resurgence of malaria after 7 years of intensive vector control interventions in Eastern Uganda.medRxiv : the preprint server for health sciences · 2024Article
- Dramatic resurgence of malaria after 7 years of intensive vector control interventions in Eastern Uganda.PLOS global public health · 2024Article
- Health workers' adherence to the malaria test, treat and track strategy during the COVID-19 pandemic in malaria high transmission area in Eastern Uganda.Malaria journal · 2023Article
- Severe malaria burden, clinical spectrum and outcomes at Apac district hospital, Uganda: a retrospective study of routine health facility-based data.Malaria journal · 2023Article
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Abstract
backgroundIn sub-Saharan Africa (SSA), malaria remains a public health problem despite recent reports of declining incidence. Severe malaria is a multiorgan disease with wide-ranging clinical spectra and outcomes that have been reported to vary by age, geographical location, transmission intensity over time. There are reports of recent malaria epidemics or resurgences, but few data, if any, focus on the clinical spectrum of severe malaria during epidemics. This describes the clinical spectrum and outcomes of childhood severe malaria during the disease epidemic in Eastern Uganda.
methodsThis prospective cohort study from October 1, 2021, to September 7, 2022, was nested within the 'Malaria Epidemiological, Pathophysiological and Intervention studies in Highly Endemic Eastern Uganda' (TMA2016SF-1514-MEPIE Study) at Mbale Regional Referral Hospital, Uganda. Children aged 60 days to 12 years who at admission tested positive for malaria and fulfilled the clinical WHO criteria for surveillance of severe malaria were enrolled on the study. Follow-up was performed until day 28. Data were collected using a customized proforma on social demographic characteristics, clinical presentation, treatment, and outcomes. Laboratory analyses included complete blood counts, malaria RDT (SD BIOLINE Malaria Ag P.f/Pan, Ref. 05FK60-40-1) and blood slide, lactate, glucose, blood gases and electrolytes. In addition, urinalysis using dipsticks (Multistix
resultsA total of 300 participants were recruited. The median age was 4.6 years, mean of 57.2 months and IQR of 44.5 months. Many children, 164/300 (54.7%) were under 5 years, and 171/300 (57.0%) were males. The common clinical features were prostration 236/300 (78.7%), jaundice in 205/300 (68.3%), severe malarial anaemia in 158/300 (52.7%), black water fever 158/300 (52.7%) and multiple convulsions 51/300 (17.0%), impaired consciousness 50/300(16.0%), acidosis 41/300(13.7%), respiratory distress 26/300(6.7%) and coma in 18/300(6.0%). Prolonged hospitalization was found in 56/251 (22.3%) and was associated with acidosis, P = 0.041. The overall mortality was 19/300 (6.3%). Day 28 follow-up was achieved in 247/300 (82.3%).
conclusionDuring the malaria epidemic in Eastern Uganda, severe malaria affected much older children and the spectrum had more of prostration, jaundice severe malarial anaemia, black water fever and multiple convulsions with less of earlier reported respiratory distress and cerebral malaria.
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