Severe forms of malaria: Outcomes in a pediatric hospital in Ouagadougou

Malaria remains the leading cause of mortality throughout the world and imposes an especially heavy burden on tropical countries. The outcome of severe malaria was evaluated prospectively at the pediatric department of the Central Ouagadougou Hospital during the periods of intense Plasmodium transmission (August to November) in 1993 and 1994. The study identified 719 patients aged 6 months to 15 years with at least one of the WHO criteria for severe and complicated malaria. All patients were treated as recommended by the WHO. Patients were divided into subgroups based on clinical symptoms, and the case-fatality rate was determined for each subgroup. Five hundred thirty patients (74.5%) achieved a full recovery, and 92 (12.9%) died. Mean hospital stay duration was 3.8 days, and 88.1% of deaths occurred before the second hospital day. Case-fatality rates were highest in patients with hypoglycemia (52.1%), respiratory distress (34.4%), or prostration (33.3%). Routine chloroquine therapy in children with fever may reduce the risk of progression of uncomplicated malaria to severe and complicated malaria.