Severe Malaria and Risk Factors for Death in the Infectious Diseases Department of the University Hospital of Fann in Dakar, Senegal
Viviane Marie Pierre Cisse *
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Khardiata Diallo Mbaye
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Aboubakar Sidikh Badiane
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Malado Diallo
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Moustapha Diop
Department of Infectious Diseases, Principal Hospital, Dakar, Senegal.
Ndèye Aïssatou Lakhe
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Ndèye Maguette Fall
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Assane Diouf
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Aminata Massaly
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Daye Ka
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Louise Fortes
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
Sylvie Audrey Diop
Department of Health, Thies University, Thies, Senegal.
Moussa Seydi
Department of Infectious and Tropical Diseases, University Hospital Center of Fann, Dakar, Senegal.
*Author to whom correspondence should be addressed.
Abstract
Aim: The aim of this study was to describe the epidemiological, clinical, paraclinical and outcome aspects of severe malaria and to determine the risk factors for death.
Methodology: This was a retrospective descriptive and analytical study of patients treated for severe malaria at the infectious and tropical diseases department of the University Hospital center of Fann between January 1, 2019 and December 31, 2021. Multivariate logistic regression was used to identify risk factors for death
Results: During our study, 138 patients were hospitalized for severe malaria over a period of 3 years, with a peak in the months of october and november. They were mostly from urban areas (68.11%). The average consultation time was 6.7 days ± 7.1 days. There was a clear male predominance, with a sex ratio of 3.18. The average age of patients was 33.96 ± 17 years. The main signs of clinical severity were coma (44.2%), prostration (36.95%) and jaundice (61.5%). Biological signs included anaemia (14.49%) and renal failure (9.42%). Severe malaria was associated with SARS Cov 2 infection in 4 patients. All patients were treated with injectable artesunate. The average length of hospitalization was 6 ± 6 days. Case fatality was 10.7. In multivariate analysis, coma (ORa =12.29 IC95%: 2.0 - 73.22 P=0.006) and severe anaemia (ORa=27.16 IC95%: 3.4 - 217.18 P=0.006) were risk factors associated with death.
Conclusion: Early recognition of the signs of seriousness and their early management thanks to improved technical facilities in intensive care units can improve the prognosis of patients.
Keywords: Severe malaria, death, risk factors, Dakar