Manifestations of Severe Malaria among the Under-five Children Attending Kampala International University Teaching Hospital, Bushenyi, Western Uganda: Pilot Study

The clinical spectrum of severe malaria has not been described in Bushenyi, hence; this study was carried out to document the prevalence, major clinical features, contributing factors and immediate outcome of this number one killer disease of under-five children, at Kampala International University Teaching Hospital (KIUTH). This is a pilot study. Study design was retrospective; carried out in the records department of KIUTH; the study population were files of children, 5 years of age and below who attended KIUTH between August and October 2009, sample size was 100 using systematic random sampling. Ethical clearance and permission were obtained. Data was collected using checklist, entered into Epi-Info version 3.2 and analysed with SPSS 16 statistical software. Prevalence of complicated malaria was 29.8%. Male: female ratio was 1.33:1. Peak age was 3years, 78% of the children had no wasting and 62% slept under treated bed nets. The three most common presentations were febrile multiple convulsions (69%), hyperparasitemia (67%) and circulatory shock (59%), prolonged coma was the least presentation (30%). The infants most commonly present with severe anaemia (60%), while the older ones manifest usually with febrile multiple convulsions (76.9%). Mortality rate was 14%, higher in the malnourished (27.3%), boys (19.3%), age 5year bracket (23.1%), with hypoglycaemia (18.8%), respiratory distress (17.9%) and multiple febrile convulsions (17.4%). The prevalence and mortality from severe malaria was high. The most common presentations were multiple febrile convulsions, hyperparasitaemia and circulatory shock. Immediate outcome was significantly affected by the nutritional status. A larger study will be done in future for a more complete picture of this problem.