Severe malaria in Cameroon: Pattern of disease in children at the Yaounde Gynaeco-Obstetric and Pediatric hospital.

ABSTRACT

BACKGROUND AND OBJECTIVE: Malaria is the most widely spread parasitic disease in the world, especially in the tropics affecting mostly children and pregnant women. In children, mostly under-fives carry the heaviest burden in terms of morbidity and mortality. The aim of this study was to determine the epidemiological and clinical aspects, and outcome of children 3 months to 15 years old with severe malaria at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH), a referral hospital in Yaounde, Cameroon. METHODS: It was a descriptive study at the general pediatric unit of the YGOPH. We enrolled all children aged 3 months to 15 years admitted for severe malaria, with one or more signs of severity and confirmed by a Rapid Diagnostic Test (RDT) and/or thick blood smear (TBS). RESULTS: Over six months, 1782 children were admitted in the unit and 466 had severe malaria giving a frequency of 26.10%. The mean age was 51±42 months, and the sex ratio was 1.2. The highest transmission rate was during the rainy season, within the months of April and May. The main symptoms on admission were prostration, fever with body temperature ≥40°C and convulsions (61.90%, 58.00%, and 30.30% respectively). RDT was positive in 98.90% of cases and TBS was positive in 60.00%. The outcome was favourable in 93.30% of the patients and 16 died giving a mortality rate of 3.80%. CONCLUSION: Severe malaria is a public health problem affecting mostly children under five years. Proper management consists of prompt diagnosis and early appropriate treatment. Prevention is by information, education and communication on environmental cleanliness and the use of insecticide-treated mosquito nets.