Outcomes and factors associated with severe malaria-related anaemia in paediatric patients in northern Nigeria.

Abstract

Objective: To determine the prevalence of anaemia, clinical features, hospitalisation outcomes, and associated factors among paediatric patients with severe malaria-related anaemia admitted to a tertiary hospital in northwestern Nigeria.

Design: This was a retrospective study of children with confirmed severe malaria-related anaemia admitted between 2019 and 2022.

Participants: Paediatric patients aged three months to 14 years with confirmed severe malaria-related anaemia.

Main outcomes measures: Hospitalization outcomes and associated factors among paediatric study patients.

Results: There were 278 malaria-related anaemia cases with a prevalence of 29.3% (278/948) among malaria cases and 3.4% (278/8,295) among all paediatric admissions. Of 278 patients with malaria-related anaemia, 110 (39.6%) had severe anaemia. The prevalence of severe anaemia was 11.6% (110/948) and 1.3% (110/8,295) from malaria cases and paediatric admissions, respectively. Clinical features were comparable across the levels of anaemia except for the loss of consciousness (p = 0.038). Severe anaemia was more common among under-fives (76/159, 47.8%), p=003, and males (p = 0.013). The crude mortality rate was 6.5% (18/278) and comparable [6.4%, (7/110)] with severe anaemia (p = 0.924). Factors that were associated with hospitalisation deaths included unconsciousness [adjusted odds ratio (AOR) 5.8, 95% confidence interval (CI) 1.800-18.441], hypoxemia AOR [7.3, 95% CI, 1.749- 30.473] and first 24 hours of admission, AOR [18.4, 95% CI 3.430-98.705].

Conclusion: In childhood, severe malaria anaemia remains a greater burden among under five and is associated with high mortality. Unconsciousness and hypoxemia at presentation and the first 24 hours of admission were associated with increased odds of death.

Funding: None declared.