Haemoglobinuria among children with severe malaria attending tertiary care in Ibadan, Nigeria
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Published:2012-10-05
Issue:1
Volume:11
Page:
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ISSN:1475-2875
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Container-title:Malaria Journal
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language:en
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Short-container-title:Malar J
Author:
Ajetunmobi Wasiu A,Orimadegun Adebola E,Brown Biobele J,Afolabi Nathaniel K,Olabiyi Folorunso A,Anetor John I,Omokhodion Samuel,Osinusi Kikelomo,Akinbami Felix O,Shokunbi Wuraola A,Sodeinde Olugbemiro,Fernandez-Reyes Delmiro
Abstract
Abstract
Background
Haemoglobinuria is one of the manifestations of severe malaria and results from severe intravascular haemolysis. Glucose-6-phosphate dehydrogenase (G6PD) deficiency has been implicated in its aetiology. Haemoglobinuria may be associated with severe anaemia and, less frequently, acute renal failure.
Methods
A prospective case-control study was carried out to determine the incidence of haemoglobinuria as confirmed by dipstick urinalysis, microscopy and spectrophotometric measurement, among children with severe malaria. A total of 251 children presenting at the Children’s Emergency Ward with severe malaria were recruited over a period of 21 months. The G6PD status and the outcomes of severe malaria in children with and without haemoglobinuria was studied with respect to renal failure, the recurrence of haemoglobinuria and blood pressure changes over a three-month follow-up period.
Results
It was found that the incidence of haemoglobinuria among children with severe malaria is 19.1%. Children <5 years constituted 76.8% of all the study patients. Patients with haemoglobinuria had median age of 52.5 months, which was significantly higher than 35 months in patients without haemoglobinuria (p=0.001). Although, haemaglobinuria was commoner among boys (54.2%) than girls (45.8%), the difference was not statistically significant. There were no significant differences between children with and without haemoglobinuria regarding their nutritional status or parasite densities. Among the clinical features of the study patients, only jaundice was significantly associated with haemoglobinuria (p=0.0001). Renal failure occurred in three out of 48 children with haemoglobinuria and in none of the 203 without. There was not recurrence of haemoglobinuria in the follow-up period. At discharge, blood pressure was elevated in six children (one previously haemoglobinuric), but all returned to normal within the follow-up period.
Conclusions
Haemoglobinuria was a prominent feature of severe malaria and it was significantly associated with jaundice at presentation. Haemoglobinuria was commoner in older children than younger children but not related to sex. G6PD deficiency was not an independent predictor of the occurrence or outcome of haemoglobinuria. Blood pressure was not affected by haemoglobinuria on admission nor during follow-up.
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Parasitology
Reference36 articles.
1. Adeyokunnu AA, Taiwo O, Antia AU: Childhood mortality among 22,255 consecutive admission in the University College Hospital, Ibadan. Nigerian Journal of Paediatrics. 1980, 1: 7-15. 2. Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJ, Sesay SS, Abubakar I, Dunyo S, Sey O, Palmer A, Fofana M, Corrah T, Bojang KA, Whittle HC, Greenwood BM, Conway DJ: Changes in malaria indices between 1999 and 2007 in the Gambia: a retrospective analysis. Lancet. 2008, 372: 1545-1554. 10.1016/S0140-6736(08)61654-2. 3. Orimadegun AE, Fawole O, Okereke JO, Akinbami FO, Sodeinde O: Increasing burden of childhood severe malaria in a Nigerian tertiary hospital: implication for control. J Trop Pediatr. 2007, 53: 185-189. 10.1093/tropej/fmm002. 4. Amzat J: Assessing the progress of malaria control in Nigeria. World Health Popul. 2011, 12: 42-51. 5. Hay SI, Guerra CA, Gething PW, Patil AP, Tatem AJ, Noor AM, Kabaria CW, Manh BH, Elyazar IR, Brooker S, Smith DL, Moyeed RA, Snow RW: A world malaria map: Plasmodium falciparum endemicity in 2007. PLoS Med. 2009, 6: e1000048-
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