Clinical and biological factors associated with treatment outcome of cerebral malaria in children under five in Yaounde.

Abstract

This is a retrospective study that was carried out in the pediatric unit of the Yaounde Central Hospital from January to August 2008. The aim of the study was to deter- mine the clinical factors associated with the treatment out- come of cerebral malaria in children under five. Included in the study were 77 children with cerebral malaria all of whom received malaria treatment either Quinine or Arteether. They were followed up from admission to discharge. ANOVA and Chi square tests were calculated and the level of signifi- cance was 0.05. The mean age of the study population was 29.68±14.20 months, and the sex ratio was 1.85. We noted 22 (29%) deaths during the course of the treatment. Clini- cal factors associated with death were fever clearance time (P = .01) and coma recovery time (P = .002). Blood glu- cose, home treatment and its duration, vomiting and fever at presentation, duration of illness, and parasite clearance time did not influence mortality. As regards biological parame- ters, the mean hemoglobin level on admission (P = .004), high blood urea levels (P = .01), and hypoglycemia (P = .01) were associated with increased deaths. Health profes- sionals should be sensitized to promptly recognize hypo- glycemia, anemia, uremia while checking fever clearance time and coma recovery time in the proper management of cerebral malaria in order to lower mortality in children under five with cerebral malaria.