ArticleWorld journal of clinical pediatrics2026
Severe malaria-bacterial sepsis co-infection among critically ill children admitted to pediatric emergency departments in Kinshasa.
Article in World journal of clinical pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSevere malaria remains a major cause of pediatric critical illness and early mortality in sub-Saharan Africa. In pediatric emergency settings, concomitant bacterial sepsis is often under-recognized because of overlapping clinical manifestations, which may delay appropriate antimicrobial therapy and worsen outcomes. Data on severe malaria-bacterial sepsis co-infection among critically ill children in Kinshasa remain limited.
aimTo determine the frequency of severe malaria-bacterial sepsis co-infection and identify the associated clinical and biological factors among critically ill children.
methodsThis prospective multicenter observational study was conducted from September 2014 to September 2015 in four pediatric emergency departments in Kinshasa, Democratic Republic of Congo. Children aged 6 months to 15 years admitted with life-threatening conditions and confirmed severe malaria were included. Bacterial sepsis was defined by a positive blood culture for a pathogenic organism. Clinical and laboratory variables were compared using Fisher's exact test and the Mann-Whitney
resultsAmong 138 children admitted with life-threatening conditions, 96 (69.6%) had confirmed severe malaria. Severe malaria-bacterial sepsis co-infection was identified in 11 children, representing 11.5% of severe malaria cases. In univariate analysis, respiratory distress, splenomegaly, and hypoglycemia were more frequent among co-infected children. In multivariable analysis, respiratory distress remained independently associated with bacterial co-infection. Early mortality in the emergency department was higher among co-infected children than among those without co-infection. Gram-negative bacteria, predominantly
conclusionSevere malaria-bacterial sepsis co-infection is relatively frequent among critically ill children in Kinshasa and is associated with poorer early outcomes. Early and systematic assessment for sepsis at admission may help improve the initial management of children in pediatric emergency settings.
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