Severe forms of malaria in children in Yaounde General Hospital Cameroon.

Severe forms of malaria in children are responsible for 1 million deaths ye arly in young children in hyperendemic areas. The main objective of this st udy was to identify and compare common manifestations of different forms of severe malaria and to evaluate the prognosis for hospital treatment in an endemic area. 271 flies of children admitted into hospital between March 1991 and Septemb er 1996 were analysed. These children were confirmed to have Plasmodium fal ciparum in their peripheral blood. 78 patients (29%) had the severe form of malaria. 43 patients (53%) were under 5 years of age. The 5 severe types i dentified were characterized by very high temperatures 28 cases (36%), cere bral malaria 20 cases (26%), prostration and weakness 15 cases (19%), sever e anaemia 14 cases (18%) and haemoglobinuria 1 case (1,3%). Cerebral malari a and severe anaemia were more common in children under 5 years old. The av erage parasitemia was 16 366 +/- 1390 parasites per microlitre. Clearance o f parasitemia was obtained on day 3 in almost all cases; 6 patients with ve ry high temperatures presented neither sign of visceral complications nor c onvulsions The average period in coma for cases of cerebral malaria was 1,7 days; 12 anaemic patients were transfused. There were no deaths. No abnorm ality was found on physical examination after an average hospitalisation of 5,3 days. An early diagnosis and adequate treatment of severe forms of malaria in chi ldren by qualified personnel will usually result in a favourable prognosis in our area.