The Clinical Profile of Severe Pediatric Malaria in an Area Targeted for Routine RTS,S/AS01 Malaria Vaccination in Western Kenya
View/ Open
Date
2020Author
Akech, Samuel
Chepkirui, Mercy
Ogero, Morris
Agweyu, Ambrose
Irimu, Grace
English, Mike
Snow, Robert W
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background
The malaria prevalence has declined in western Kenya, resulting in the risk of neurological phenotypes in older children. This study investigates the clinical profile of pediatric malaria admissions ahead of the introduction of the RTS,S/AS01 vaccine.
Methods
Malaria admissions in children aged 1 month to 15 years were identified from routine, standardized, inpatient clinical surveillance data collected between 2015 and 2018 from 4 hospitals in western Kenya. Malaria phenotypes were defined based on available data.
Results
There were 5766 malaria admissions documented. The median age was 36 months (interquartile range, 18–60): 15% were aged between 1–11 months of age, 33% were aged 1–23 months of age, and 70% were aged 1 month to 5 years. At admission, 2340 (40.6%) children had severe malaria: 421/2208 (19.1%) had impaired consciousness, 665/2240 (29.7%) had an inability to drink or breastfeed, 317/2340 (13.6%) had experienced 2 or more convulsions, 1057/2340 (45.2%) had severe anemia, and 441/2239 (19.7%) had severe respiratory distress. Overall, 211 (3.7%) children admitted with malaria died; 163/211 (77% deaths, case fatality rate 7.0%) and 48/211 (23% deaths, case fatality rate 1.4%) met the criteria for severe malaria and nonsevere malaria at admission, respectively. The median age for fatal cases was 33 months (interquartile range, 12–72) and the case fatality rate was highest in those unconscious (44.4%).
Conclusions
Severe malaria in western Kenya is still predominantly seen among the younger pediatric age group and current interventions targeted for those <5 years are appropriate. However, there are increasing numbers of children older than 5 years admitted with malaria, and ongoing hospital surveillance would identify when interventions should target older children.
URI
https://academic.oup.com/cid/article/71/2/372/5554744http://erepository.uonbi.ac.ke/handle/11295/153456
Citation
Samuel Akech, Mercy Chepkirui, Morris Ogero, Ambrose Agweyu, Grace Irimu, Mike English, Robert W Snow, The Clinical Profile of Severe Pediatric Malaria in an Area Targeted for Routine RTS,S/AS01 Malaria Vaccination in Western Kenya, Clinical Infectious Diseases, Volume 71, Issue 2, 15 July 2020, Pages 372–380, https://doi.org/10.1093/cid/ciz844Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10378]
The following license files are associated with this item: