Differences between hospitalized and non-hospitalized children 12 years and below with malaria in Kasangati, Uganda

Abstract

Degree Project Thesis, Programme in Medicine. TITLE: Differences between hospitalized and non-hospitalized children 12 years and below with malaria in Kasangati, Uganda. Background: Malaria is the second most common cause of death among children below the age of five, and the third most common cause of death among adults in Uganda. Early diagnosis and treatment within 24 hours after onset of symptoms are important to avoid uncomplicated malaria developing to severe malaria. One way to reduce unnecessary use of antimalarial drugs, which increases the risk of resistance is to test all patients with suspected malaria with RDTs or microscopy before treatment according to WHO’s recommendations. Aim: To find out what distinguish children with malaria that are admitted and children with uncomplicated malaria that are not admitted at Kasangati Health Centre. Methods: A cross-sectional study where semi-structured interviews were conducted with caretakers of not admitted and admitted children 0-12 years with malaria, using a questionnaire and interpreters. Information regarding other current diseases and medication were taken from patient books and upper arm measurements were measured. Results: More of the admitted children were receiving treatment within 12 hours from start of symptoms than outpatients (admitted 63% vs outpatients 20%) and admitted were more often coming to the health centre within 12 hours after start of first symptom (admitted 47% vs outpatients 8%). The admitted children had more diarrhea, general body pain, inability to sit up though she/he normally can, inability to play and rapid breathing. Admitted children had also more pneumonia than the outpatients (22% vs 3%). Conclusions: Caretakers of children that are more severe ill choose to seek medical care faster. The admitted children had more symptoms of complicated malaria and more pneumonia than non-admitted children. Further studies should be done on community level to evaluate the situation of the whole population.