CLINICAL PROFILE AND HAEMATOLOGICAL INDICES OF CHILDREN WITH SEVERE ANAEMIA DUE TO MALARIA AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL

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CLINICAL PROFILE AND HAEMATOLOGICAL INDICES OF CHILDREN WITH SEVERE ANAEMIA DUE TO MALARIA AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL

Abstract

Severe malaria anaemia is a common cause of admission and childhood deaths in
emergency paediatric units in malaria endemic regions. Late diagnosis of this
illness is fraught with risks likewise its management modalities. A clearer
understanding of the burden and features of this illness is essential to provide the
rational intervention for affected children.
This descriptive cross-sectional study was conducted at the Emergency Paediatric
Unit of the University of Ilorin Teaching Hospital with the aim of determining the
prevalence, clinical features and laboratory findings of children with severe
malaria anaemia.
Ninety three (93) children with packed cell volume (PCV) less than 15% and
malaria parasitaemia were recruited while controls were age and sex matched
children with malaria and PCV >15%. Clinical data were recorded in a study
proforma while blood samples were drawn for full blood count, Mean Corpuscular
Volume (MCV), Mean Corpuscular Haemoglobin (MCH), thick and film blood
films for presence of malaria parasite and parasite count, haemoglobin
electrophoresis and ABO blood group.
The prevalence of severe anaemia was 9% among all hospital admissions and it
constituted 45.9% of all cases of severe malaria in the Emergency Paediatric Unit.
Children younger than 24 months constituted 60% of the study population. The
mean age of children with severe malaria anaemia was 24.01 ± 14.2 months.
Clinical features among the subjects included hepatomegaly (93%), splenomegaly
(62.4%), tachycardia (39.8%) and tachypnea (35.5%). About 28% of the subjects
had a combination of tachycardia, tachypnea and tender hepatomegaly while
similar findings were was found in 5.4% of the controls ( 2 = 17.07; p = 0.01). It
was observed that presentation to the hospital within 3 days of onset of illness had
significant association with cardiac decompensation (p =0.03).
Laboratory findings revealed that 50% of the subjects had PCV between 12% and
15%. The mean PCV of the children in the study was 11.2 ± 2.24%. Signs of
cardiac decompensation were demonstrated by similar proportions of subjects with
PCV ≤ 12% and those with PCV between 12% and 15% showing that
decompensation occurs across both PCV ranges below 15%. About 20% of the
subjects had low MCV values for age.
Blood film examination revealed that leucopenia and thrombocytopenia
significantly occurred among the subjects than controls. (p = 0.001) The mean
parasite count among children with severe malaria anaemia was 499,450.43 ±
449,018.98parasites/ml and hyperparasitemia was found to be a significant finding
among children younger than 24 months compared to controls.
This study has demonstrated the clinical burden of severe malaria anaemia as a
common indication for admission of young children into emergency units
particularly children less than 24 months of age. The common clinical and
laboratory presentation of this disease were also highlighted. This study suggests a
multifactorial aetiology for SMA and also confirming that majority of affected
children are clinically stable without signs of decompensation. Therefore
prevention and proper management of this disease are important to reduce
morbidity and mortality associated with malaria.

CLINICAL PROFILE AND HAEMATOLOGICAL INDICES OF CHILDREN WITH SEVERE ANAEMIA DUE TO MALARIA AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL

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