Kouéta Fla, Dao Lassina, Yé Diarra, Zoungrana Alice, Kaboré Aïssata, Sawadogo Alphonse
Unité de formation et de recherche en sciences de la santé (UFR/SDS), Université de Ouagadougou, Service de pédiatrie médicale du CHUP-CDG, BP 1198 BP 01, Ouagadougou 01, Burkina Faso.
Sante. 2007 Oct-Dec;17(4):195-9. doi: 10.1684/san.2007.0089.
To determine the risk factors for death from severe malaria in children in Burkina Faso, we conducted a retrospective case-control study covering a period of 24 months from January 2004 through December 2005, at the Charles de Gaulle Pediatric Hospital in Ouagadougou. Cases (n=72) were defined as all children hospitalized for and dying of confirmed severe malaria. The control subjects (n=72), matched for age, sex and date of hospitalization; were children hospitalized for confirmed severe malaria who were discharged after recovery. Risk factors assessed included: place of residence, socioeconomic level, self-medication, promptness of hospitalization, nutritional status, temperature and parasitemia. Case and control children were compared with pairwise tests. Low socioeconomic level (OR=5.4), late care (OR=15.5), poor nutritional status (OR=7.9) and a parasitemia greater than or equal to 5% (OR=2.8) were associated with a significant increase in the risk of death. In contrast, the malaria deaths were not associated with place of residence (OR=0.5), self-medication (OR=1) or fever of 41 degrees C or higher (OR=1.1). These results show the need for more health education to encourage early care-seeking in the event of fever, community-based interventions, and strengthening of the technical support centers for health facilities, as part of a national poverty reduction program.
为确定布基纳法索儿童重症疟疾死亡的危险因素,我们于2004年1月至2005年12月期间,在瓦加杜古的夏尔·戴高乐儿童医院开展了一项为期24个月的回顾性病例对照研究。病例(n = 72)定义为所有因确诊重症疟疾住院并死亡的儿童。对照对象(n = 72)按年龄、性别和住院日期匹配,为确诊重症疟疾住院后康复出院的儿童。评估的危险因素包括:居住地点、社会经济水平、自我用药、住院及时性、营养状况、体温和寄生虫血症。病例组和对照组儿童采用成对检验进行比较。社会经济水平低(比值比=5.4)、就医延迟(比值比=15.5)、营养状况差(比值比=7.9)以及寄生虫血症大于或等于5%(比值比=2.8)与死亡风险显著增加相关。相比之下,疟疾死亡与居住地点(比值比=0.5)、自我用药(比值比=1)或体温41摄氏度及以上(比值比=1.1)无关。这些结果表明,作为国家减贫计划的一部分,需要开展更多健康教育,以鼓励发热时尽早寻求医疗服务,实施社区干预措施,并加强卫生设施的技术支持中心。