Journal of Tropical Pediatrics, 2015, 61, 272–278
Published by Oxford University Press
ABSTRACT
The decline of susceptibility of Plasmodium falciparum to chloroquine and sulfadoxine–pyrimethamine resulted in the change of drug policy. This policy has probably changed the facies of the severe form of malaria. A prospective study was conducted in Kinshasa, the Democratic Republic of Congo. Data on children aged 13 years, diagnosed with severe malaria were analyzed. In total, 378 children were included with an overall median age of 8 years (age range: 1–13 years). Dark urine was seen in 25.1% of cases. Metabolic acidosis (85.2%), hypoglycemia (62.2%) and hemoglobin 5 g/dl (39.1%) were the common laboratories features. Severe malaria anemia, cerebral malaria
and Blackwater fever (BWF) were found in 39.1, 30.1 and 25.4%, respectively. Mortality rate was 4%. BWF emerges as a frequent form of severe malaria in our midst. Availing artemisin-based combination treatments in the health care system is a priority to reduce the incidence of BWF in our environment.
KEYWORDS:
Plasmodium falciparum, severe malaria, Blackwater fever, children, drugs policy,
Kinshasa, Democratic Republic Democratic of Congo, Africa