Lokengama Kwambele, Grace Ndeezi, Yamile Arias Ortiz, Sabinah Twesigemuka, Martin Nduwimana, Walufu Ivan Egesa, Patrick Kumbowi Kumbakulu, Yves Tibamwenda Bafwa
{"title":"乌干达Kiryandongo总医院重症疟疾患儿急性肾损伤相关因素","authors":"Lokengama Kwambele, Grace Ndeezi, Yamile Arias Ortiz, Sabinah Twesigemuka, Martin Nduwimana, Walufu Ivan Egesa, Patrick Kumbowi Kumbakulu, Yves Tibamwenda Bafwa","doi":"10.1155/2023/2139016","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Malaria remains one of the leading health problems of the developing world, and acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults; but the clinical importance of AKI in paediatric severe malaria is not well documented. Knowledge of the prevalence and factors associated with AKI among children with severe malaria is among the key strategies, which can help to reduce the burden of AKI among this vulnerable group. <i>Methodology</i>. A hospital-based prospective cross-sectional descriptive and analytic study of children with severe malaria was carried out at Kiryandongo General Hospital. The study involved 350 children with severe malaria attending the study site from August to October 2021. Questionnaires were administered to caretakers to obtain sociodemographic characteristics. Medical data were obtained through physical examination followed by laboratory tests. Blood samples were tested for creatinine and blood smear for malaria. Data were analyzed using binary logistic regression (bivariate and multivariate) to assess for the factors associated with AKI. A <i>p</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age of children with severe malaria was 7.0 ± 3.8 years, and 54.3% of them were male. Of the 350 children enrolled, 167 had AKI, giving an overall AKI prevalence of 47.7% (95% CI: 42.5-53.0). The factors that were significantly associated with AKI among children with severe malaria included caretaker with no formal education (aOR = 21.0, 95% CI: 1.68-261.18, <i>p</i> = 0.018), caretaker with primary education level (aOR = 4.5, 95% CI: 1.41-14.12, <i>p</i> = 0.011), age of child < 5 years (aOR = 1.8, 95% CI: 1.07-2.88, <i>p</i> = 0.025), history of receiving NSAIDs (aOR = 5.6, 95% CI: 2.34-13.22, <i>p</i> < 0.001), moderate anemia (aOR = 3.1, 95% CI: 1.39-6.94, <i>p</i> = 0.006), and severe anemia (aOR = 3.8, 95% CI: 1.66-8.55, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The prevalence of AKI was high among children with severe malaria in Kiryandongo General Hospital. Acute kidney injury among children with severe malaria was associated with low level of education of caretakers, age of children less than 5 years, history of receiving NSAIDs, and anemia. The management of severe malaria should include screening for AKI especially in children under five years of age, anemic, and those who have received NSAIDs.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349672/pdf/","citationCount":"0","resultStr":"{\"title\":\"Factors Associated with Acute Kidney Injury among Children with Severe Malaria at Kiryandongo General Hospital, Uganda.\",\"authors\":\"Lokengama Kwambele, Grace Ndeezi, Yamile Arias Ortiz, Sabinah Twesigemuka, Martin Nduwimana, Walufu Ivan Egesa, Patrick Kumbowi Kumbakulu, Yves Tibamwenda Bafwa\",\"doi\":\"10.1155/2023/2139016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Malaria remains one of the leading health problems of the developing world, and acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults; but the clinical importance of AKI in paediatric severe malaria is not well documented. Knowledge of the prevalence and factors associated with AKI among children with severe malaria is among the key strategies, which can help to reduce the burden of AKI among this vulnerable group. <i>Methodology</i>. A hospital-based prospective cross-sectional descriptive and analytic study of children with severe malaria was carried out at Kiryandongo General Hospital. The study involved 350 children with severe malaria attending the study site from August to October 2021. Questionnaires were administered to caretakers to obtain sociodemographic characteristics. Medical data were obtained through physical examination followed by laboratory tests. Blood samples were tested for creatinine and blood smear for malaria. Data were analyzed using binary logistic regression (bivariate and multivariate) to assess for the factors associated with AKI. A <i>p</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age of children with severe malaria was 7.0 ± 3.8 years, and 54.3% of them were male. Of the 350 children enrolled, 167 had AKI, giving an overall AKI prevalence of 47.7% (95% CI: 42.5-53.0). The factors that were significantly associated with AKI among children with severe malaria included caretaker with no formal education (aOR = 21.0, 95% CI: 1.68-261.18, <i>p</i> = 0.018), caretaker with primary education level (aOR = 4.5, 95% CI: 1.41-14.12, <i>p</i> = 0.011), age of child < 5 years (aOR = 1.8, 95% CI: 1.07-2.88, <i>p</i> = 0.025), history of receiving NSAIDs (aOR = 5.6, 95% CI: 2.34-13.22, <i>p</i> < 0.001), moderate anemia (aOR = 3.1, 95% CI: 1.39-6.94, <i>p</i> = 0.006), and severe anemia (aOR = 3.8, 95% CI: 1.66-8.55, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The prevalence of AKI was high among children with severe malaria in Kiryandongo General Hospital. Acute kidney injury among children with severe malaria was associated with low level of education of caretakers, age of children less than 5 years, history of receiving NSAIDs, and anemia. The management of severe malaria should include screening for AKI especially in children under five years of age, anemic, and those who have received NSAIDs.</p>\",\"PeriodicalId\":51591,\"journal\":{\"name\":\"International Journal of Pediatrics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349672/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/2139016\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/2139016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
背景:疟疾仍然是发展中国家的主要健康问题之一,急性肾损伤(AKI)是公认的成人严重疟疾并发症;但AKI在儿童重症疟疾中的临床重要性尚未得到充分证明。了解严重疟疾患儿中AKI的患病率和相关因素是关键策略之一,有助于减轻这一弱势群体的AKI负担。方法。在Kiryandongo总医院对患有严重疟疾的儿童进行了一项以医院为基础的前瞻性横断面描述性和分析研究。该研究涉及350名患有严重疟疾的儿童,于2021年8月至10月期间参加了研究。对护理人员进行问卷调查以获得社会人口学特征。医疗数据是通过体格检查和实验室检查获得的。对血液样本进行了肌酐检测和疟疾血涂片检测。使用二元逻辑回归(双变量和多变量)分析数据以评估与AKI相关的因素。p值< 0.05认为有统计学意义。结果:重症疟疾患儿平均年龄为7.0±3.8岁,男性占54.3%;在纳入的350名儿童中,167名患有AKI,总体AKI患病率为47.7% (95% CI: 42.5-53.0)。显著相关的因素与安琪儿童重症疟疾包括看守没有正规教育(优势比= 21.0,95%置信区间CI: 1.68 - -261.18, p = 0.018),看守初等教育水平(优势比= 4.5,95%置信区间CI: 1.41 - -14.12, p = 0.011),孩子年龄< 5年(优势比= 1.8,95%置信区间CI: 1.07 - -2.88, p = 0.025),历史上接收非甾体抗炎药(aOR = 5.6, 95%置信区间CI: 2.34 - -13.22, p < 0.001),中度贫血(优势比= 3.1,95%置信区间CI: 1.39 - -6.94, p = 0.006),和严重贫血(优势比= 3.8,95%置信区间CI:1.66-8.55, p = 0.002)。结论:基里扬东戈总医院重症疟疾患儿AKI患病率较高。严重疟疾患儿的急性肾损伤与护理人员教育水平低、儿童年龄小于5岁、接受非甾体抗炎药史和贫血有关。严重疟疾的管理应包括AKI筛查,特别是在5岁以下儿童、贫血儿童和接受过非甾体抗炎药的儿童中。
Factors Associated with Acute Kidney Injury among Children with Severe Malaria at Kiryandongo General Hospital, Uganda.
Background: Malaria remains one of the leading health problems of the developing world, and acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults; but the clinical importance of AKI in paediatric severe malaria is not well documented. Knowledge of the prevalence and factors associated with AKI among children with severe malaria is among the key strategies, which can help to reduce the burden of AKI among this vulnerable group. Methodology. A hospital-based prospective cross-sectional descriptive and analytic study of children with severe malaria was carried out at Kiryandongo General Hospital. The study involved 350 children with severe malaria attending the study site from August to October 2021. Questionnaires were administered to caretakers to obtain sociodemographic characteristics. Medical data were obtained through physical examination followed by laboratory tests. Blood samples were tested for creatinine and blood smear for malaria. Data were analyzed using binary logistic regression (bivariate and multivariate) to assess for the factors associated with AKI. A p value < 0.05 was considered statistically significant.
Results: The mean age of children with severe malaria was 7.0 ± 3.8 years, and 54.3% of them were male. Of the 350 children enrolled, 167 had AKI, giving an overall AKI prevalence of 47.7% (95% CI: 42.5-53.0). The factors that were significantly associated with AKI among children with severe malaria included caretaker with no formal education (aOR = 21.0, 95% CI: 1.68-261.18, p = 0.018), caretaker with primary education level (aOR = 4.5, 95% CI: 1.41-14.12, p = 0.011), age of child < 5 years (aOR = 1.8, 95% CI: 1.07-2.88, p = 0.025), history of receiving NSAIDs (aOR = 5.6, 95% CI: 2.34-13.22, p < 0.001), moderate anemia (aOR = 3.1, 95% CI: 1.39-6.94, p = 0.006), and severe anemia (aOR = 3.8, 95% CI: 1.66-8.55, p = 0.002).
Conclusion: The prevalence of AKI was high among children with severe malaria in Kiryandongo General Hospital. Acute kidney injury among children with severe malaria was associated with low level of education of caretakers, age of children less than 5 years, history of receiving NSAIDs, and anemia. The management of severe malaria should include screening for AKI especially in children under five years of age, anemic, and those who have received NSAIDs.
期刊介绍:
International Journal of Pediatrics is a peer-reviewed, open access journal that publishes original researcharticles, review articles, and clinical studies in all areas of pediatric research. The journal accepts submissions presented as an original article, short communication, case report, review article, systematic review, or letter to the editor.