Umuhire Larrisa, Dushimiyimana Violette, Nkuranyabahizi Michel, Ngendahayo Flavien, Shyaka Jean Claude, Ngerageze Innocent, Rajeswaran Lakshmi, Chironda Geldine
University of Rwanda, College of Medicine and Health Sciences, School of Nursing and Midwifery, Kigali, Rwanda.
Seed Global Health, Sant John of God College of Health Sciences, Mzuzu, Malawi.
Afr Health Sci. 2024 Sep;24(3):81-89. doi: 10.4314/ahs.v24i3.12.
Acute kidney injury (AKI) remains one of the complications of severe malaria. Evidence on associated factors and outcomes for patients with complicated malaria and AKI is limited in Rwanda.
To assess the factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda.
A retrospective study design was applied. A census sampling strategy was used to select 122 files of patients admitted as severe malaria patients in 2016-2017. A developed clinical audit form was used to collect data from patients' files. Both descriptive and inferential statistics were used to analyze data.
Among the confirmed severe malaria files, 44% of participants were over 50 years and 52.5% were males. The majority, (91.5%) had community-based health insurance and 16.3% had acute kidney injury. The significant associated clinical factors were dehydration (p=.01), high-grade fever (p=.002), profuse sweating (p=.034), vomiting (p=.043), and diarrhea (p=.025). Of the 20 patients who developed AKI, 55% completely recovered, 15% died and 30% of cases were transferred to the highest facilities for hemodialysis.
The existence of AKI among severe malaria patients was evident with some recovering and others dying. There is a need for educating healthcare professionals, mostly at district hospitals about the diagnosis and management of AKI as a result of complicated malaria.
急性肾损伤（AKI）仍然是重症疟疾的并发症之一。在卢旺达，关于复杂疟疾和AKI患者的相关因素及预后的证据有限。
评估卢旺达一家地区医院疟疾患者急性肾损伤的相关因素及预后。
采用回顾性研究设计。使用普查抽样策略选取2016 - 2017年收治的122例重症疟疾患者的病历。使用编制好的临床审计表从患者病历中收集数据。采用描述性和推断性统计方法分析数据。
在确诊的重症疟疾病历中，44%的参与者年龄超过50岁，52.5%为男性。大多数（91.5%）拥有社区医疗保险，16.3%发生急性肾损伤。显著相关的临床因素有脱水（p = 0.01）、高热（p = 0.002）、大量出汗（p = 0.034）、呕吐（p = 0.043）和腹泻（p = 0.025）。在发生AKI的20例患者中，55%完全康复，15%死亡，30%的病例被转至上级医疗机构进行血液透析。
重症疟疾患者中存在AKI，一些患者康复，另一些患者死亡。由于复杂疟疾导致的AKI，有必要对医疗专业人员（主要是地区医院的人员）进行诊断和管理方面的培训。
