Malaria remains most frequent severe infection in migrants from north to South Sudan

Background: Malaria is still one of the most frequented diseases in South Sudan. With its longterm consequences - anemia, malnutrition, liver dysfunctions and others, is particularly dangerous for children, where mortality for neonates is 13% and for children under 5 years old 7%. Aim: Purpose of this study was to assess proportion of severe malaria among all admissions within years 2013-2016, in hospital located in area with internally displaced population in South Sudan. Patients and methods: 1777 patients presented with severe malaria, diagnosis of severe malaria was confirmed rapid diagnostic testing (RDT) and thick blood smear. Results: In total, 1777 patients had severe malaria clinically presented as fever plus severe anemia, or respiratory distress syndrome, or cerebral malaria, liver or kidney failure, or severe hypoglycemia with acidosis. Of 1777 patients within 2 years, 224 died (all children < 5 years) - mortality 4.5 %. Most common fatal complications were severe anemia, kidney failure, hypoglycemia, coma due to CNS involvement and severe acidosis. Conclusion: Severe malaria among refugees is still associated with substantial morbidity and mortality. Mortality on severe malaria decreased within last 10 years, below 10% in children, however sequellae still remain a problem in long term follow up.