Severe Malaria Comorbidity and Bacterial Infections in Children at the Pediatric Department of Tengandogo University Hospital

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Résumé

Abstract
Objective: To investigate the clinical, biological, and outcome characteristics
of children hospitalized for severe malaria, and to identify factors associated
with bacterial co-infection at Tengandogo University Hospital. Methods: A
cross-sectional, descriptive, and analytical study was conducted from August to
October 2022 in the pediatric department. Children aged 1 month to 15 years
hospitalized for severe malaria according to WHO criteria were included. Bac-
terial co-infections were defined by suspected or confirmed clinical, biological
(elevated CRP, leukocytosis), radiological, and/or microbiological data. Data
were collected from medical records and analyzed using Epi Info 7.22.2.6. Chi-
square tests were used to compare proportions, with significance set at p <
0.05. Results: Of 129 children hospitalized for severe malaria, 45 (34.9%) had
bacterial co-infection. The most common infections were bronchopulmonary
infections (33.3%), gastroenteritis (17.8%), and urinary tract infections (15.6%).
Major clinical signs included coma (51.1%), respiratory distress (48.9%), and
severe anemia (68.9%). Mean parasite density was 74,218/µL. . Significant risk
factors were low socioeconomic status (OR = 2.85), poor general condition
(OR = 2.81), coma (OR = 4.12), respiratory distress (OR = 3.77), hypoglycemia
< 2.2 mmol/L (OR = 5.74), and in-hospital death (OR = 5.00). Overall case fa-
tality was 20%. Conclusion: Bacterial co-infection is frequent in severe pediatric
malaria and worsens prognosis. Systematic screening based on simple criteria is
essential to optimize management. According to our findings, coma, respiratory
distress, and hypoglycemia should be used as simple screening criteria.
Keywords
Severe Malaria, Bacterial Co-Infection, Child, Burkina Faso

Mots-clés

Severe Malaria, Bacterial Co-Infection, Child, Burkina Faso