Health care related factors associated with severe malaria in children in Kampala, Uganda.
BACKGROUND
Severe malaria is responsible for the high load of malaria mortality. It is not clearly understood why some malaria episodes progress to severe malaria.


OBJECTIVE
To determine factors associated with severe malaria in children aged 6 months to 5 years living in Kampala.


METHODS
Over a 6-month period, 100 children with severe malaria were matched by age and place of residence with 100 children with non-severe malaria. We collected health care information from care takers.


RESULTS
Mean duration of illness before getting antimalarial treatment was shorter for controls than cases (8 hours vs. 20 hours, p 0.015). Children with severe malaria were less likely to have been treated with sulphadoxine-pyrimethamine in the preceding 2 weeks (OR 0.2, 95% CI 0.04-0.85, p 0.016). Odds of severe malaria were higher in those who reported lack of protective measures (mosquito coils (OR = 20.63, 95% CI 1.5-283.3, p=0.02 and insecticide sprays OR 10.93, 95% CI 1.13-105.64, p=0.03), although few reported their use.


CONCLUSIONS
Early anti-malarial treatment and use of barriers against mosquitoes prevent severe malaria in children. There is need to increase the use of barriers against mosquito bites and to scale up prompt treatment and community-based interventions to reduce the incidence of severe malaria in children.
Byakika-Kibwika
P
P
Makerere University, School fo Medicine, Department of Medicine, Kampala, Uganda. pbyakika@gmail.com
Ndeezi
G
G
Kamya
M R
MR
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D009032:Mosquito Control; D018512:Parasitemia / Q000175:diagnosis; D010342:Patient Acceptance of Health Care; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
D000962:Antimalarials