Bittaye Sheikh Omar, Jagne Abubacarr, Jaiteh Lamin E S, Amambua-Ngwa Alfred, Sesay Abdul Karim, Ramirez Williams Estrada, Ramos Asmell, Effa Emmanuel, Nyan Ousman, Njie Ramou
Department of Internal Medicine Edward Francis Small Teaching Hospital Banjul The Gambia.
School of Medicine and Allied Health Sciences University of The Gambia Banjul The Gambia.
Health Sci Rep. 2025 Jan 22;8(1):e70401. doi: 10.1002/hsr2.70401. eCollection 2025 Jan.
Cerebral malaria in Gambian children has been studied but there is limited information on CM in adults. The study assesses the clinical features and outcome of CM in adult patients admitted at the Edward Francis Small Teaching Hospital.
This was a retrospective review of all adult patients with malaria admitted to the internal medicine department from October 18, 2020 to February 2, 2022.
A total number of 319 adults were admitted with malaria. Eighty (25%) patients met the criteria for CM. The median age of the CM patients was 19 years. CM patients were younger ( < 0.001), more likely to be of the adolescent age group ( < 0.001), more likely to be referred from a lower-level health facility ( < 0.001), and more likely to be admitted in intensive care < 0.001) as compared to NSCM or UM patients. The total in-hospital mortality of CM patients was 23.8%. Ten (52.6%) out of the 19 patients died within the first 24 h of admission. In multivariate analysis, CM patients with acute kidney injury at presentation was an independent predictor of mortality in this study.
CM seems to affect the adolescent age group more than the older adults in The Gambia. The clinicians should be able to identify these high-risk patient group and institute prompt critical care interventions and/or treatment. The findings in this study also identify the need to expand access of critical care interventions and hemodialysis to help improve the prognosis of adult CM patients in The Gambia.
冈比亚儿童脑型疟疾已得到研究，但关于成人脑型疟疾的信息有限。本研究评估了在爱德华·弗朗西斯·斯莫尔教学医院住院的成年患者脑型疟疾的临床特征及预后。
这是一项对2020年10月18日至2022年2月2日内科收治的所有成年疟疾患者的回顾性研究。
共有319名成年疟疾患者入院。80名（25%）患者符合脑型疟疾标准。脑型疟疾患者的中位年龄为19岁。与非脑型重症疟疾或未分型疟疾患者相比，脑型疟疾患者更年轻（P<0.001），更可能处于青少年年龄组（P<0.001），更可能从基层医疗机构转诊而来（P<0.001），且更可能入住重症监护病房（P<0.001）。脑型疟疾患者的院内总死亡率为23.8%。19名患者中有10名（52.6%）在入院后24小时内死亡。在多变量分析中，入院时伴有急性肾损伤的脑型疟疾患者是本研究中死亡率的独立预测因素。
在冈比亚，脑型疟疾似乎对青少年年龄组的影响大于老年人。临床医生应能够识别这些高危患者群体，并及时开展重症监护干预和/或治疗。本研究结果还表明，需要扩大重症监护干预和血液透析的可及性，以帮助改善冈比亚成年脑型疟疾患者的预后。
