title: In-hospital morbidity and mortality due to severe malarial anemia in western Kenya.
abstract: Severe malarial anemia (SMA) is a leading cause of pediatric morbidity, hospitalization, and mortality in sub-Saharan Africa, and yet its contribution to malaria-specific mortality is not well documented. We retrospectively reviewed the clinical records of 1,116 children < 5 years of age admitted to Siaya district hospital, western Kenya, to assess the contribution of SMA to overall in-hospital mortality. Of 1,116 admissions, 86% were under 3 years, 83% had malaria parasitemia, 86% were anemic, 21% were severely anemic, and 20% were transfused. Severe anemia was associated with parasitemia in 85% of the admissions and contributed to 53% of malaria-related deaths. Overall, 83 (7.5%) children died; 66% of those deaths were malaria-related, 12% had severe anemia, and 89% were under 3 years. Transfusion did not lower mortality rates. In areas of high malaria transmission, children below 3 years are a high-risk group for malaria, anemia, blood transfusion, and mortality.
authors.affiliation: Centre for Vector Biology & Control Research, Kenya Medical Research Institute, Kisumu, Kenya. Cobonyo@kisian.mimcom.net
authors.forename: Charles O
authors.initials: CO
authors.lastname: Obonyo
authors.forename: John
authors.initials: J
authors.lastname: Vulule
authors.forename: Willis S
authors.initials: WS
authors.lastname: Akhwale
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D000740:Anemia / Q000097:blood / Q000469:parasitology* / Q000628:therapy; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000097:blood* / Q000188:drug therapy / Q000401:mortality* / Q000469:parasitology; D008297:Male; D009017:Morbidity; D010963:Plasmodium falciparum; D012189:Retrospective Studies
chemical_list: D000962:Antimalarials