Severe Malaria in Adults at the Yalgado Ouédraogo University Hospital of Ouagadougou, Burkina Faso: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects

Aims: To describe the epidemiological, clinical, therapeutic and evolutionary characteristics of severe malaria in adults at the Yalgado Ouédraogo University Hospital from 2004 to 2021.

Methodology: This was a cross-sectional study, with retrospective data collection covering the period from January 1, 2004 to December 31, 2021. Patients with severe malaria diagnosed on the basis of clinical and biological signs, with a positive thick blood drop were included.

Results: During the study period, a total of 217 cases of severe malaria were recorded, representing a hospital prevalence of 2.1%. The mean age of the patients was 40 years ± 20 with extremes ranging from 18 years to 92 years. Females predominated (52.8%) compared to 47.2% for males, i.e. a sex ratio of 0.89. Thirty percent of the patients lived in urban areas, 24% in semi-urban areas and 46% in rural areas. They were mostly housewives, farmers, pupils or students. Clinically, the functional signs of our patients were dominated by neurological signs, digestive signs and respiratory signs. The physical examination noted a systemic inflammatory response syndrome and multivisceral failure in the majority of patients. Biological disturbances were dominated by renal failure, severe anemia, thrombocytopenia and metabolic acidosis. Comorbidities were dominated by arterial hypertension, HIV infection and diabetes. Under treatment, the evolution was marked by a case fatality of 29.5%.

Conclusion: In clinical practice, severe malaria in adults is rare but potentially serious. It is frequently responsible for sepsis associated with multivisceral failure. Its prognosis depends on the rapidity of the diagnosis and the initiation of appropriate treatment.