Abstract:

Background: In Tanzania malaria is the leading cause of morbidity and mortality, especially in Children under 5 years. The disease ranks number one in both outpatient and inpatient statistics. The socio-economic impact of malaria is so high that it contributes highly to poverty and under development. Malaria control and elimination interventions have been scaled up and intensified as the current efforts to attain World Health Assembly (60th meeting in May 2007), Roll Back Malaria (launched in 1998), The Abuja Declaration on Roll Back Malaria in Africa (established 25th April 2000, Abuja, Nigeria) and Millennium development targets (established in the year 2000), to reduce and interrupt disease transmission. The major malaria intervention tools now include: The use of long-lasting Insecticidal Nets (LLIN), Artemisinin-based Combination therapy (ACT) like artesunate and Artmether-Lumefantrine (ALU), Indoor Residual Spraying of Insecticide (IRS), malaria prophylaxis for travelers in endemic regions and Intermittent Preventive Treatment in Pregnancy (IPT). Despite these interventions the prevalence remains high among the under five children. (38)

Objective: To determine the prevalence and outcomes of severe malaria among under eleven years old children admitted at Kagera Regional Hospital from July 2012 to June 2013.

Methods: A retrospective hospital based cross-sectional study using constructed checklist in which files and registration books were used to collect data and then analyzed.

Results: A total of 365 children admitted out of 3580 had a diagnosis of severe malaria, the prevalence of severe malaria was 10.2%, the most affected group were aged 0-2 years (175 children) (47.9%), followed by 3-5 years (117 children) (32.1%) and then 6-11 years (73 children) (20.0%). Most children presented with features of severe anemia (165 children) (45.2%) followed by prostration (91 children) (24.9%), hypoglycemia (82 children) (22.5%) and lastly respiratory distress (27 children) (7.4%). Among these 365 children some presented also with features of cerebral malaria whereby 78 children (21.4%) had episodes of convulsions, 6 children (1.6%) had impaired level of consciousness and 5 children (1.4%) had coma. Among these 365 children, 290 (79.5%) survived and 75 (20.5%) died.

Conclusion: Malaria continues to be a major health problem in Kagera region, therefore more should be done in an effort to prevent and properly treat severe malaria by educating the parents and caretakers to bring their child to hospital without delay when they become sick, encouraging sleeping under long lasting insecticide treated nets (LLITNS’s) and clearing bushes, removing stagnant water around the households so as destroy the breeding sites of mosquitoes. Also using Artemisinin based combination therapy in treatment of malaria. Delay in treatment especially of cases caused by Plasmodium falciparum result in rapid deterioration in the patient’s condition and in the development of life threatening complications. Recognizing and prompt treating uncomplicated malaria is therefore of vital importance.