Severe malaria in children and adolescents in Southeast Gabon

• Published in: BMC infectious diseases 2023-04, Vol.23 (1), p.207-207, Article 207
• Main Authors: Lendongo Wombo, Judicaël Boris, Ibinga, Euloge, Oyegue-Liabagui, Sandrine Lydie, Imboumy Limoukou, Roméo Karl, Okouga, Alain Prince, Mounioko, Franck, Maghendji-Nzondo, Sydney, Lekana-Douki, Jean Bernard, Ngoungou, Edgard Brice
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Age groups; Anemia; Blood; Child; Child, Preschool; Children; Coma; Consciousness; Convulsions; Data collection; Demographic aspects; Developing countries; Development and progression; Disease transmission; Distribution; Emergency medical care; Epidemiology; Females; Gabon; Gabon - epidemiology; Health care facilities; Health facilities; Hemoglobin; Hospital facilities; Hospitals; Humans; Hypoglycemia; Infant; Infectious diseases; Jaundice; Laboratories; LDCs; Malaria; Malaria - epidemiology; Malaria prevalence; Malaria, Falciparum - diagnosis; Medical records; Medical research; Medicine, Experimental; Metabolism; Microscopy; Mortality; Parasites; Patients; Plasmodium falciparum; Public health; Rural areas; Seizures; Severe forms; Severe malaria; Signs; Sub-Saharan Africa; Teenagers; Urban areas; Urbanization; Vector-borne diseases
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08133-y

Malaria remains a significant public health problem in sub-Saharan Africa. Child mortality due to severe malaria remains high in developing countries despite improvements in malaria management and a better understanding of its pathophysiology. To address the lack of epidemiological studies on severe malaria in Gabon, this study describes the epidemiological aspects of severe malaria in rural, semi-rural, and urban areas of southeast Gabon. Demographic, clinical, and laboratory data for children and adolescents aged 0-18 years were collected in 2019 from hospital records at three health facilities in southeastern Gabon. The patients included in the study were positive for P falciparum malaria diagnosed by microscopy with at least one of the malaria severity criteria. Severe malaria accounted for 18.8% (667/3552) of malaria cases. Children aged 0-5 years accounted for 71.8% (479/667) of all severe malaria cases. Adolescents over 15 years of age were the least affected by severe malaria with 4.2% (28/667). Across the study, severe anemia (49.0%, 327/667), convulsions (43.0%, 287/667), respiratory distress (5.1%, 34/667), and altered consciousness (4.8%, 32/667) were the most frequent clinical signs of severe malaria in children. Franceville was the locality most affected by severe malaria with 49.2% (328/667), followed by Koulamoutou with 42.0% (280/667) and Lastourville with 8.8% (59/667). Convulsions (50.6%, 166/328) and coma (6.1%, 20/328) were more frequent in children living in urban areas. In contrast, severe anemia (56.7%, 186/339) and jaundice (6.8%, 23/339) were more common in children living in semi-rural areas. Severe malaria is more prevalent in urban areas in regions with a high malaria transmission intensity. However, in this study, the epidemiological characteristics of severe malaria were similar in the three settings (urban, rural, and semi-rural areas) despite different levels of urbanization. Nevertheless, the various signs of severity were more frequent in Franceville, an urban area. Children under 5 years of age remain the most vulnerable age group.