The Prevalence and Treatment Outcomes of Children Admitted with Cerebral Malaria at Kampala International University Teaching Hospital Pediatrics’ Ward

Table of Contents

ACKNOWLEDGEMENT................................................................................................................................i

DECLARATION ............................................................................................................................................ii

APPROVAL ..................................................................................................................................................iii

List of tables ..................................................................................................................................................vi

ABSTRACT .................................................................................................................................................vii

CHAPTER ONE .............................................................................................................................................1

1.1 INTRODUCTION:....................................................................................................................................1

1.1 Background .....................................................................................................................................1

1.2 Problem statement:...........................................................................................................................2

1.3 Justification .....................................................................................................................................3

1.4 Aim And Objectives.........................................................................................................................3

CHAPTER TWO ............................................................................................................................................4

2.0 LITERATURE REVIEW: ...................................................................................................................4

2.1 Prevalence:...............................................................................................................................................4

2.2 Clinical Presentation:.................................................................................................................................5

2.2.1 Coma:.....................................................................................................................................................5

2.2.2 Seizures:.................................................................................................................................................5

2.2.3 Brainstem signs: .....................................................................................................................................6

2.2.4 Retinal changes: .....................................................................................................................................6

2.2.5 Hypoglycemia ........................................................................................................................................6

CHAPTER THREE.........................................................................................................................................8

3.0 METHODS .........................................................................................................................................8

3.1 STUDY DESIGN......................................................................................................................................8

3.2 STUDY AREA..........................................................................................................................................8

3.3 STUDY POPULATION............................................................................................................................8

3.4 SAMPLE SIZE..........................................................................................................................................8

3.5 INCLUSION AND EXCLUSION CRITERIA...........................................................................................8

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3.6 ETHICAL CONSIDERATION ................................................................................................................9

3.7 DATA COLLECTION METHODS........................................................................................................9

3.8 DATA MANAGEMENT..........................................................................................................................9

3.9 DATA QUALITY CONTROL ............................................................................................................... 10

CHAPTER FOUR......................................................................................................................................... 11

4.0 RESULTS ......................................................................................................................................... 11

CHAPTER FIVE........................................................................................................................................... 14

5.0 DISCUSSION, CONCLUSION AND RECOMMENDATIONS........................................................ 14

5.1 DISCUSSION ......................................................................................................................................... 14

5.1.1 Prevalence ............................................................................................................................................ 14

5.1.2 Clinical Presentation............................................................................................................................. 14

5.1.3 Outcomes ............................................................................................................................................. 15

5.2 Conclusions............................................................................................................................................. 16

5.3 Recommendations ................................................................................................................................... 16

REFERENCES: ............................................................................................................................................ 17

ABSTRACT Malaria continues to cause significant morbidity and mortality globally with ninety per cent of deaths occurring in Sub-Saharan Africa. Cerebral malaria, one of the most severe neurological complications of malaria, still causes about 20% deaths and another 25% survive with neurological symptoms. It is still responsible for up to fifty per cent of hospital malaria admissions. With a mortality rate of up to 75%, cerebral malaria is responsible for between 10% and 50% of the admissions due to malaria across Africa. Aim To find out the prevalence and treatment outcomes of children admitted with cerebral malaria at Kampala International University-Teaching Hospital (KIU-TH) Methods A retrospective study was done at KIU-TH whereby all children with cerebral malaria admitted to the paediatric ward between 1st June, 2013 and 31st May, 2014 were included in the study. The required information based on the clerkship notes and laboratory results were obtained, put on spread sheet and analysed manually to yield frequencies, percentages and tables of the various variables. Results The prevalence of cerebral malaria among the children admitted with CM at KIU-TH was 17.6%. There were more males than females and 52.4% of them where aged from 0 to less than five years. Fever was the present in 71.4%, convulsions in 64.3% and anaemia in 50% of the children. The least common presentations were eye changes (2.3%) and hypoglycemia (11.9%). Another 11.9% died and 2.3% had plegia or paresis at discharge. Only 9.5% of the children spent 0 -2 days and 52.4% spent 3- 5 days. Conclusions and recommendations The prevalence of CM remains high and the children under five years remain vulnerable to the disease. Children presenting with fever, convulsions and anaemia should also be assessed for malaria and the current efforts should be reinforced so as to significantly reduce the number of prevalence of cerebral malaria cases and its complications.