Internal Medicine Department, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia.
Malar J. 2023 Sep 1;22(1):253. doi: 10.1186/s12936-023-04691-3.
Malaria remains a major public health concern in The Gambia. The study assessed the trend of malaria admissions and outcome of adult patients admitted after the start of the COVID-19 pandemic in a tertiary hospital in The Gambia.
This was a retrospective hospital-based study and data was collected from the 18th October 2020 to 28th February 2023. Demographic data, clinical features, investigations, treatment, and outcomes were recorded.
A total of 499 malaria cases were admitted to the hospital over the 29 months of the study period. Data from 320 (67.2% of the total cases) adult patients admitted into the internal medicine department were analysed. The median age was 22 years, range (15-90) and 189 (59.1%) cases were youth with a youth (15-24 years) to older adult (> 24 years) ratio of 1.4:1. The majority of the patients were male 199 (62.2) with a male to female ratio of 1.6:1. The total number of malaria cases admitted into the internal medicine department increased from 103 cases in 2021 to 182 cases in 2022and admission peaked in November in both years. The total number of admitted malaria cases during the peak of the malaria season also increased from 92 patients between September 2021 and December 2021 to 132 patients from September 2022 to December 2022.There was also an increase in both severe and uncomplicated malaria during the same period. The total mortality was 31 (9.7%) and the rate was similar in 2021 9 (8.7%) and 2022 15 (8.4%). Patients with impaired consciousness were more likely to die when compared to those without impaired consciousness [19 (23.6%) vs 12 (5%), p ≤ 0.001]. Patients with acute kidney injury were also more likely to die when compared with those without acute kidney injury [10 (20.4%) vs 15 (7.7%), p = 0.009].
The findings show an emerging and consistent trend of malaria admissions and the outcome in the youth and older adult population after the start of the COVID-19 pandemic in The Gambia. This, therefore, suggests the need for the implementation of targeted malaria prevention interventions in this population to further prevent the spread of the disease to the more vulnerable population.
疟疾仍然是冈比亚的一个主要公共卫生问题。本研究评估了 COVID-19 大流行开始后，冈比亚一家三级医院成年疟疾住院患者的趋势和结局。
这是一项回顾性医院研究，数据收集时间为 2020 年 10 月 18 日至 2023 年 2 月 28 日。记录了人口统计学数据、临床特征、检查、治疗和结局。
在 29 个月的研究期间，共有 499 例疟疾患者住院。对 320 例（总病例数的 67.2%）内科住院患者的数据进行了分析。中位年龄为 22 岁，范围（15-90）岁，189 例（59.1%）为青年，青年（15-24 岁）与老年（>24 岁）患者的比例为 1.4:1。大多数患者为男性 199 例（62.2%），男女比例为 1.6:1。内科住院的疟疾病例总数从 2021 年的 103 例增加到 2022 年的 182 例，在这两年中，11 月的入院人数最多。疟疾高发季节的住院疟疾病例总数也从 2021 年 9 月至 12 月的 92 例增加到 2022 年 9 月至 12 月的 132 例。同期严重和非复杂性疟疾的病例也有所增加。总死亡率为 31%（9.7%），2021 年和 2022 年的死亡率相似，分别为 9 例（8.7%）和 15 例（8.4%）。与意识正常的患者相比，意识障碍患者死亡的可能性更高[19 例（23.6%）比 12 例（5%），p≤0.001]。与无急性肾损伤的患者相比，有急性肾损伤的患者死亡的可能性更高[10 例（20.4%）比 15 例（7.7%），p=0.009]。
研究结果显示，冈比亚 COVID-19 大流行开始后，青年和老年人群中疟疾住院人数和结局呈现有增无减的趋势。因此，这表明需要在该人群中实施有针对性的疟疾预防干预措施，以进一步防止疾病向更脆弱的人群传播。
