[An update on severe pediatric malaria in Central Africa hospital units].
OBJECTIVE
The authors had for aim, to determine the frequency and the main clinical forms of severe malaria and to evaluate its management.


METHODS
A cross-sectional investigation was made in the "Complexe Pediatrique" of Bangui, the only children hospital of the CAR capital, from 12 January to 12 September 1998. The survey included children 6 months to 15 years of age presenting on admission with a positive thick drop examination, and at least one of the clinical symptoms of severe malaria as defined by the World Organization of Health (WHO).


RESULTS
Four hundred and thirty-two children were included. Those from 6 months to 4 years of age accounted for 89.35% of the studied population. The most frequent clinical forms were neurological 31% and anemic 22.2%; the other forms were combined in 42.8%. Managing patients consisted of an etiologic treatment by quinine (91.7%) or sulfadoxine pyrimethamine (3.2%) and symptomatic treatment in the following proportions: rehydration: 49.3%; blood transfusion: 36.3%; preventing seizure: 72.9%; oxygen therapy: 77.5%; use of antipyretics: 96.7%, and correction of hypoglycemia: 9%. The death rate remained high with 62 deaths (14.35%). It was higher in combined forms (48 deaths out of 62).


CONCLUSIONS
Severe malaria and its various clinical forms remain a major problem for our pediatric intensive care unit. Updated technical means and human resources could improve the management of severe pediatric malaria.
Bobossi Serengbe
G
G
Clinique médicale infantile, complexe pédiatrique de Bangui, BP 607, Bangui, Centrafrique. ser-bob@caramail.com
Ndoyo
J
J
Gaudeuille
A
A
Longo
J D D
JD
Bezzo
M E
ME
Ouilibona
S F
SF
Ayivi
B
B
D000293:Adolescent; D000962:Antimalarials / Q000627:therapeutic use; D002488:Central African Republic / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D012720:Severity of Illness Index
D000962:Antimalarials