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Severe falciparum malaria in young children is associated with an increased risk of post-discharge hospitalization: a prospective cohort study.
Malar J
December 2024
Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indiana, USA.
Article Synopsis
- A study conducted in Uganda followed children aged 6 months to 4 years who were discharged from the hospital after being treated for specific severe malaria manifestations, comparing their post-discharge health to asymptomatic community children.
- Over 12 months, 56.6% of children with severe malaria experienced one or more hospitalizations, significantly higher than the 30.8% of community children, with a majority of the hospitalizations being malaria-related.
- The findings indicate a pressing need for research into post-discharge malaria prevention treatments to help reduce the healthcare burden on children who have suffered from severe malaria.
Introduction: Few studies have described post-discharge morbidity of children with specific manifestations of severe malaria (SM) beyond severe malarial anemia or cerebral malaria.
Methods: Children 6 months to 4 years of age admitted at Jinja and Mulago hospitals in Uganda, with one or more of the five most common manifestations of SM, cerebral malaria (n=53), respiratory distress syndrome (n=108), malaria with complicated seizures (n=160), severe malarial anemia (n=155) or prostration (n=75), were followed for 12 months after discharge, along with community children (CC) (n=120) recruited from the household or neighborhood of the children with SM. Incidence and risk of post-discharge readmission, death or outpatient clinic visits were compared between children with SM and CC.
Elevated levels of PDGF-BB and VEGF are associated with a decreased risk of readmission or death in children with severe malarial anemia.
J Infect Dis
October 2024
Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Article Synopsis
- Children with severe malarial anemia (SMA) have low in-hospital mortality but face high risks of readmission or death after discharge, potentially due to factors impacting blood production and vascular health.
- A study of 145 children in Kampala, Uganda, showed that higher plasma levels of platelet-derived growth factor-BB (PDGF-BB) and vascular endothelial growth factor (VEGF) upon admission were linked to a significantly lower risk of readmission or death within 12 months.
- The findings suggest that these angiogenesis-promoting factors may help reduce the likelihood of severe malaria recurrences in these children.
Quality of care and post-discharge morbidity among children diagnosed with severe malaria in rural Uganda: A prospective cohort study.
PLOS Glob Public Health
October 2024
Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Article Synopsis
- Pediatric severe malaria is a major health issue in Uganda, particularly in rural areas, where there is limited information on routine care and post-discharge outcomes.
- A study conducted at St. Paul's Level IV Health Center in Kasese involved 187 children with confirmed malaria, revealing that most received appropriate treatment per WHO guidelines, but many experienced post-discharge symptoms like fever and nausea.
- The study highlighted the need for further research into pediatric severe malaria management and outcomes in rural settings, as there were six recorded deaths related to the condition.
Perceived barriers and opportunities for the introduction of post-discharge malaria chemoprevention (PDMC) in five sub-Saharan countries: a qualitative survey amongst malaria key stakeholders.
Malar J
September 2024
Medicines for Malaria Venture (MMV), Route de Pre-Bois 20, 1215, Meyrin, Switzerland.
Background: Post-discharge malaria chemoprevention (PDMC) is an intervention aimed at reducing morbidity and mortality in patients hospitalized with severe anaemia, with its effectiveness established in several clinical trials. The aim of this study was to better understand factors that would influence the scale up of this intervention, and to identify preferences for two delivery mechanisms, facility-based or community-based.
Methods: Forty-six qualitative individual interviews were conducted in five sub-Saharan countries amongst malaria key opinion leaders and national decision makers.
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