title: [Influence of the age and the level of transmission on the clinical and biological expression of severe malaria in children].
abstract: BACKGROUND
  This study aimed to determine the influence of the age and the level of malaria transmission on the clinical and biological expression of severe malaria in children.
  
  
  METHODS
  A prospective descriptive study was conducted in nine referral hospitals in Kinshasa. A total of 1350 children, less than 15years old and hospitalized for severe malaria, were progressively included in the study between January and November 2011.
  
  
  RESULTS
  The majority of these children (74.5%) were less than 5years of age. Major syndromes were severe anemia (11.4%), cerebral malaria (27.1%), and respiratory distress (20.5%). Severe anemia and cerebral malaria were associated with the age of the child and not the area transmission. On the other hand, respiratory distress was associated with high malaria transmission areas (P<0.05). After adjustment, these associations were maintained. High malaria lethality was observed in the group of children aged 12-59months (11.6%) and those from areas of high malaria transmission (8.4%).
  
  
  CONCLUSIONS
  The child's age and level of transmission are associated with certain severe types of childhood malaria. Early and appropriate support would reduce the most fatal consequences associated with severe childhood malaria.
authors.affiliation: Institut supérieur des techniques médicales de Kinshasa, RD, Congo; Research centre in epidemiology, biostatistics and clinical research, school of public health, université libre de Bruxelles, Brussels, Belgique. Electronic address: filungai@ulb.ac.be.
authors.forename: F
authors.initials: F
authors.lastname: Ilunga-Ilunga
authors.affiliation: Research centre in epidemiology, biostatistics and clinical research, school of public health, université libre de Bruxelles, Brussels, Belgique.
authors.forename: A
authors.initials: A
authors.lastname: Levêque
authors.affiliation: Research centre in epidemiology, biostatistics and clinical research, school of public health, université libre de Bruxelles, Brussels, Belgique.
authors.forename: M
authors.initials: M
authors.lastname: Dramaix
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000740:Anemia / Q000469:parasitology; D000962:Antimalarials / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007260:Infusion Pumps; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission*; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000635:transmission; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification*; D011446:Prospective Studies; D011803:Quinine / Q000008:administration & dosage; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D011803:Quinine