Risk Factors for Mortality in Children Hospitalized with Severe Malaria in Northern Zambia: A Retrospective Case-Control Study

Author

Matthew Ippolito

Application Date

2016 Fall

Mentor

Bill Moss (Epidemiology)

Country

Zambia

Authors:Matthew M. Ippolito, Luc K. Kamavu, Jean-Bertin Kabuya, Catherine Tente, Edward Chileshe, McBerth Wapachole, Philip E. Thuma, Mbanga Muleba, Mike Chaponda, Modest Mulenga, and William J. Moss

Publication Year: 2018

Abstract. Malaria remains a public health crisis in areas where it has resisted control efforts. In Nchelenge District, a high-transmission area in northern Zambia, malaria accounts for more than one-third of pediatric hospitalizations and nearly one-half of hospital deaths in children. To identify risk factors for death due to malaria, we conducted a retrospective, time-matched case-control study of 126 children hospitalized with malaria who died (cases) and 126 children who survived (controls). There were no differences in age, gender, hemoglobin concentration, or prevalence of severe anemia between cases and controls. Children who died were more likely to come from villages located at greater distances from the hospital than children who survived (median 13.5 versus 3.2 km). Each additional kilometer of distance from the hospital increased the odds of death by4%(odds ratio 1.04,95%confidence interval 1.01–1.07,P < 0.01). Extent of anemia and admission during periods when blood was unavailable for transfusion were associated with early death (P £ 0.03). Delays in initiation of treatment of severe malaria contribute to the increased odds of death in children referred from more distant health centers, and might be mitigated by transportation improvements, capacity at rural health posts to administer treatment before transfer, hospital triage systems that minimize time to treatment, and reliable blood product stores at referral hospitals.
 

You can access a PDF of the publication here.

Paul S. Lietman Award, Fall 2016

People

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...
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