Trends of Incidence and Outcomes of Childhood Severe Malaria in a Tertiary Health Facility in Nigeria: A 4-Year Cross-Sectional Study from 2019 to 2022

IF 0.2 4区医学 Q4 INFECTIOUS DISEASES

Journal of Pediatric infectious diseases Pub Date : 2024-07-05 DOI:10.1055/s-0044-1788059

Olayinka Rasheed Ibrahim, Michael Abel Alao, Amudalat Issa, Bashir Mohammed, Bello Mohammed Suleiman, Olugbenga Ayodeji Mokuolu

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Abstract

Objective Nigeria ranks highest globally in malaria burden, disproportionately affecting children. This study investigated trends in the incidence and outcomes of 948 children with cases of severe malaria in a tertiary hospital in northwestern Nigeria.

Methods We conducted a retrospective cross-sectional study of children with severe malaria between January 1, 2019, and December 31, 2022. We extracted relevant data, including sociodemographics, clinical features, as well as hospitalization outcomes (death or discharge), and the trends analyzed over the period.

Results Of the 8,295 pediatric admissions during the study period, 948 (11.4%) were cases of severe malaria. The trends of severe malaria (incidence) showed a surge of 17.3% in 2020 from 11.4% in 2019 and subsequently declined to 9.9% in 2022 (p < 0.001). There was a decline in the proportion of under-fives with severe malaria from 47.5% observed in 2019 to 43.7% in 2022 (p = 0.019). The overall mortality rate (malaria specific) was 7.2% (68/948) which rose from 2.3% in 2019 to 10.3% in 2020 and declined to 8.5% in 2022, p = 0.003. The proportion of malaria-specific deaths (from all-cause mortality) increased from 4.6% in 2019 to 17.3% in 2020 and declined to 9.3% in 2022 (p = 0.004). Among under-fives, there was no significant change in the malaria-specific mortality rate (from 3.2% in 2019 to 10.2% in 2020, 6.4% in 2021 and 10.3% in 2022, p = 0.104) and the proportion of malaria-specific deaths in under-fives among malaria deaths (from 66.7% in 2019 to 52.9% in 2022, p = 0.653). Among the clinical features, the presence of cerebral malaria and acute kidney injury had the highest case fatality rate (57.1%).

Conclusion Despite the initial surge in severe malaria cases during the coronavirus disease 2019 era, there has been an overall progressive decline in childhood severe malaria. However, among those under-fives, the trends in malaria deaths remained unchanged.

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尼日利亚一家三级医疗机构中儿童重症疟疾的发病趋势和结果：2019年至2022年的四年横断面研究

目标尼日利亚的疟疾负担居全球之首，对儿童的影响尤为严重。本研究调查了尼日利亚西北部一家三级医院的 948 名重症疟疾患儿的发病率和预后趋势。方法我们对 2019 年 1 月 1 日至 2022 年 12 月 31 日期间的重症疟疾患儿进行了回顾性横断面研究。我们提取了相关数据，包括社会人口统计学、临床特征和住院结果（死亡或出院），并分析了期间的趋势。结果在研究期间的8295例儿科住院病例中，948例（11.4%）为重症疟疾病例。重症疟疾（发病率）的趋势显示，从2019年的11.4%激增到2020年的17.3%，随后又下降到2022年的9.9%（P = 0.019）。总死亡率（疟疾特异性）为 7.2%（68/948），从 2019 年的 2.3% 上升到 2020 年的 10.3%，到 2022 年下降到 8.5%，p = 0.003。疟疾特异性死亡（全因死亡）比例从 2019 年的 4.6% 上升至 2020 年的 17.3%，到 2022 年降至 9.3%（p = 0.004）。在五岁以下儿童中，疟疾特异性死亡率（从2019年的3.2%上升到2020年的10.2%、2021年的6.4%和2022年的10.3%，p = 0.104）和五岁以下儿童疟疾特异性死亡占疟疾死亡人数的比例（从2019年的66.7%下降到2022年的52.9%，p = 0.653）没有显著变化。在临床特征中，出现脑型疟疾和急性肾损伤的病例死亡率最高（57.1%）。结论尽管在 2019 年冠状病毒病时期，重症疟疾病例最初激增，但儿童重症疟疾病例总体上逐渐减少。然而，在五岁以下儿童中，疟疾死亡的趋势保持不变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric infectious diseases Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： The Journal of Pediatric Infectious Diseases is a peer-reviewed medical journal publishing articles in the field of child infectious diseases. The journal provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques used in diagnosis and treatment of childhood infectious diseases. The following articles will be considered for publication: editorials, original and review articles, rapid communications, letters to the editor and book reviews. The aim of the journal is to share and disseminate knowledge between all disciplines in the field of pediatric infectious diseases.