title: Blackwater fever in Congolese children: a report of clinical, laboratory features and risk factors.
abstract: BACKGROUND
  Blackwater fever (BWF) is one of the severe forms of malaria. This complication was first described among non-immune European expatriates in the malaria endemic areas. Recently, resurgence of this form of malaria has been reported among the indigenous populations. The objective of this study was to investigate the risk factors among BWF patients.
  
  
  METHODS
  A case-control study was conducted between in four hospitals located in Kinshasa, Democratic Republic of Congo from January 2010 to December 2011. One hundred and twenty nine children were recruited with 43 (cases) and 86 (control).
  
  
  RESULTS
  No significant difference in the gender and age distribution was observed between the case and control). The sex-ratio male to female in the case group and control group was respectively 1:1.0 and 1:1.1. The mean age was 8.62 years (SD = 3.84) in patients with haemoglobinuria and 8.55 years (SD = 3.77) in the control group. No difference in frequency of co-infection with Plasmodium falciparum and Plasmodium malariae was observed between the two groups. Significant differences in haemoglobin, haematocrit, creatinine, urea and platelets levels were observed between the two groups (p < 0.001), but not for blood group and lactate dehydrogenase (LDH) level. Majority of the BWF cases occurred during the rainy season (88.4%). Treatment with quinine (95.3%) was significantly associated with cases (p < 0.001). Seven (16.2%) of the haemoglobinuric children developed acute renal failure.
  
  
  CONCLUSIONS
  Rainy season, low parasitaemia and quinine ingestion were the major risk factors significantly associated with haemoglobinuria. Acute renal failure was observed as the major complication of BWF.
authors.affiliation: Department of Paediatrics, Paediatric Emergency and Intensive Care Unit, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo. jbodi1@yahoo.fr
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Bodi
authors.forename: Célestin N
authors.initials: CN
authors.lastname: Nsibu
authors.forename: Roland L
authors.initials: RL
authors.lastname: Longenge
authors.forename: Michel N
authors.initials: MN
authors.lastname: Aloni
authors.forename: Pierre Z
authors.initials: PZ
authors.lastname: Akilimali
authors.forename: Pierre M
authors.initials: PM
authors.lastname: Tshibassu
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Kayembe
authors.forename: Ahmeddin H
authors.initials: AH
authors.lastname: Omar
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirayama
authors.forename: Jan
authors.initials: J
authors.lastname: Verhaegen
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001742:Blackwater Fever / Q000453:epidemiology* / Q000473:pathology*; D001769:Blood / Q000469:parasitology; D001774:Blood Chemical Analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D008288:Malaria / Q000150:complications*; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010965:Plasmodium malariae / Q000302:isolation & purification; D011803:Quinine / Q000627:therapeutic use; D012307:Risk Factors; D012621:Seasons; D017678:Sex Distribution; D014556:Urine / Q000737:chemistry
chemical_list: D011803:Quinine