PREDICTORS OF MORTALITY IN GAMBIAN CHILDREN WITH SEVERE MALARIA ANEMIA

Severe malaria anaemia is a frequent cause of admission to hospital in tropical Africa and about 10% of children with this condition die. To determine ways in which mortality might be reduced we have studied ri sk factors for a fatal outcome in 173 children with severe malaria ana emia who were assigned to receive blood transfusion because they had a packed cell volume of less than 12% and/or signs of respiratory distr ess. Twenty-three children died (13%); in 15 cases (65%) death occurre d before blood transfusion was given. The presence of respiratory dist ress was found to be the most important predictor of death. Children w ith severe malaria anaemia and signs of respiratory distress must ther efore be transfused as soon as possible.