title: Severe malaria in children: A descriptive report from Kinshasa, the Democratic Republic of Congo.
abstract: The decline of susceptibility of Plasmodium falciparum to chloroquine and sulfadoxine-pyrimethamine resulted in the change of drug policy. This policy has probably changed the facies of the severe form of malaria. A prospective study was conducted in Kinshasa, the Democratic Republic of Congo. Data on children aged ≤13 years, diagnosed with severe malaria were analyzed. In total, 378 children were included with an overall median age of 8 years (age range: 1-13 years). Dark urine was seen in 25.1% of cases. Metabolic acidosis (85.2%), hypoglycemia (62.2%) and hemoglobin ≤5 g/dl (39.1%) were the common laboratories features. Severe malaria anemia, cerebral malaria and Blackwater fever (BWF) were found in 39.1, 30.1 and 25.4%, respectively. Mortality rate was 4%. BWF emerges as a frequent form of severe malaria in our midst. Availing artemisin-based combination treatments in the health care system is a priority to reduce the incidence of BWF in our environment.
authors.affiliation: Division of Intensive Care, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo Department of Pediatrics, Hôpital Général de Référence de N'djili, Institut Supérieur de Techniques Médicales, Kinshasa, Democratic Republic of Congo.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Kunuanunua
authors.affiliation: Division of Intensive Care, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Célestin N
authors.initials: CN
authors.lastname: Nsibu
authors.affiliation: Division of Intensive Care, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Bodi
authors.affiliation: Department of Pediatrics, Hôpital Général de Référence de N'djili, Institut Supérieur de Techniques Médicales, Kinshasa, Democratic Republic of Congo.
authors.forename: Thérèse K
authors.initials: TK
authors.lastname: Tshibola
authors.affiliation: Department of Pediatrics, Hôpital Général de Référence de N'djili, Institut Supérieur de Techniques Médicales, Kinshasa, Democratic Republic of Congo.
authors.forename: Mimy
authors.initials: M
authors.lastname: Makusi Bura
authors.affiliation: Department of Pediatrics, Hôpital Général de Référence de N'djili, Institut Supérieur de Techniques Médicales, Kinshasa, Democratic Republic of Congo.
authors.forename: Kumbundu
authors.initials: K
authors.lastname: Magoga
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Mathilde B
authors.initials: MB
authors.lastname: Ekila
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Hypolite T
authors.initials: HT
authors.lastname: Situakibanza
authors.affiliation: Division of Haemato-oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo michelaloni2003@yahoo.fr.
authors.forename: Michel N
authors.initials: MN
authors.lastname: Aloni
mesh_terms: D000138:Acidosis / Q000453:epidemiology / Q000469:parasitology; D000293:Adolescent; D000740:Anemia; D000962:Antimalarials / Q000008:administration & dosage* / Q000627:therapeutic use; D001742:Blackwater Fever / Q000150:complications / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D010963:Plasmodium falciparum / Q000187:drug effects*; D015995:Prevalence; D011446:Prospective Studies; D011803:Quinine / Q000008:administration & dosage* / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D011803:Quinine
keywords: Africa; Blackwater fever; Democratic Republic Democratic of Congo; Kinshasa; Plasmodium falciparum; children; drugs policy; severe malaria