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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Severe malaria and concomitant bacteraemia in children admitted to a rural Mozambican hospital
Tropical Medicine and International Health, Volume 14, No. 9, Year 2009
Notification
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Description
Objectives To describe the prevalence, aetiology and prognostic implications of coexisting invasive bacterial disease in children admitted with severe malaria in a rural Mozambican Hospital. Methods Retrospective study of data systematically collected from June 2003 to May 2007 in a rural Mozambican hospital, from all children younger than 5 years admitted with severe malaria. Results Seven thousand and forty-three children were admitted with a diagnosis of malaria. 25.2% fulfilled the criteria for severe malaria. 5.4% of the children with severe malaria and valid blood culture results had a concomitant bacteraemia. Case fatality rates of severe malaria cases rose steeply when bacteraemia was also present (from 4.0% to 22.0%, P < 0.0001), and bacteraemia was an independent risk factor for death among severe malaria patients (adjusted OR 6.2, 95% CI 2.8-13.7, P = 0.0001). Streptococcus pneumoniae, Gram-negative bacteria, Staphilococcus aureus and non-typhoid Salmonella (NTS) were the most frequently isolated microorganisms among severe malaria cases. Their frequency and associated case fatality rates (CFR) varied according to age and to syndromic presentation. Streptococcus pneumoniae had a relatively low CFR, but was consistently associated with severe malaria syndromes, or anaemia severity groups. No clear-cut relationship between malarial anaemia and NTS bacteraemia was found. Conclusions The coexistence of malaria and invasive bacterial infections is a frequent and life-threatening condition in many endemic African settings. In Mozambique, S. pneumoniae is the leading pathogen in this interaction, possibly as a consequence of the high HIV prevalence in the area. Measures directed at reducing the burden of both those infections are urgently needed to reduce child mortality in Africa. © 2009 Blackwell Publishing Ltd.
Authors & Co-Authors
Bassat, Quique
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Guinovart, Caterina
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Sigaúque, Betuel
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Mandomando, Inácio M.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Aíde, Pedro
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Sacarlal, J.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Universidade Eduardo Mondlane
Nhampossa, Tacilta
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Bardají, Azucena
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Morais, Luís
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
MacHevo, Sónia
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Universidade Eduardo Mondlane
Letang, Emilio
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
MacEte, Eusébio V.
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Aponte, John Jairo
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Roca, Anna
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Menéndez, Clara
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Alonso, Pedro Luís
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Statistics
Citations: 112
Authors: 16
Affiliations: 4
Identifiers
Doi:
10.1111/j.1365-3156.2009.02326.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Mozambique