ABSTRACT
Introduction: The high burden of Malaria morbidity and mortality in children is due to its potential to cause multi-organ dysfunction. There is however limited information on the specific electrocardiographic features in falciparum malaria in paediatric age group. Aim: To investigate the electrocardiographic (ECG) features in children with (complicated) severe falciparum malaria (SM) and acute uncomplicated malaria (AUM) at the University College Hospital, Ibadan. Methods: This was a comparative cross-sectional study conducted among 398 children with symptomatic and confirmed Plasmodium falciparum malaria and apparently healthy controls. The frequencies of ECG features were described and compared among these children. Results: The prevalence of ECG abnormality was 79.7% and 63.2% in Severe Malaria SM and Acute uncomplicated malaria AUM patients, respectively. Sinus tachycardia was significantly more frequent in SM than AUM and control groups (p <0.001). The risk of an ECG abnormality was about three times higher in SM than healthy children (p<0.001; OR=2.89;95%CI[1.68,4.99). Conclusion: Severe malaria patients had significant ECG abnormalities (Sinus Tachycardia).
Introduction: Le fardeau élevé de la morbidité et de la mortalité du paludisme chez les enfants est dû à son potentiel de provoquer un dysfonctionnement de plusieurs organes. Il existe cependant des informations limitées sur les caractéristiques électro cardiographiques spécifiques du paludisme à falciparum dans le groupe d'âge pédiatrique. Objectif de l'étude: Étudier les caractéristiques électro cardiographiques (ECG) chez les enfants atteints de paludisme à falciparum sévère (compliqué) et de paludisme aigu non compliqué (AUM) dans l'hôpital du collège universitaire d'Ibadan. Méthode de l'étude: Il s'agissait d'une étude transversale comparative menée auprès de 398 enfants atteints de paludisme à plasmodium falciparum symptomatique et confirmé et de témoins apparemment sains. Les fréquences des caractéristiques ECG ont été décrites et comparées chez ces enfants. Résultat de l'étude: La prévalence des anomalies de l'ECG était de 79,7 % et 63,2 % chez les patients atteints de paludisme grave SM et de paludisme aigu non compliqué AUM, respectivement. La tachycardie sinusale était significativement plus fréquente dans les groupes SM que dans les groupes AUM et témoin (p <0,001). Le risque d'anomalie de l'ECG était environ trois fois plus élevé chez les SM que chez les enfants sains (p<0,001; OR=2,89; IC95 %[1,68, 4,99]). Conclusion: les patients atteints de paludisme grave présentaient des anomalies significatives de l'ECG (tachycardie sinusale).
ABSTRACT
In order to determine the age at diagnosis of sickle cell disease and some of the factors that influence the same at the University College Hospital Ibadan, a retrospective study of children with sickle cell disease who attended the children's outpatient department of the hospital between June 2000 and June 2009 was conducted by reviewing their case notes. A total of 457 children were studied (Male: Female ratio 1.1:1). Haemoglobin phenotype was SS in 421 children (92.1%) and SC in 36 children (7.9 %). Median age at diagnosis was 2.0 years (2.5 months - 14.0 years). Age at diagnosis was lower in children with Hb SS than HbSC (p = 0.01), in children from higher socioeconomic classes (p = 0.003) and in children with a history of dactylitis (N = 354, p = 0.000). Late diagnosis of haemogobinopathies in Ibadan calls for institution of neonatal screening to improve chances of survival.
