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Frequency of severe malaria and invasive bacterial infections among children admitted to a rural hospital in Burkina Faso

Maltha, Jessica, Guiraud, Issa, Kaboré, Bérenger, Lompo, Palpouguini, Ley, Benedikt, Bottieau, Emmanuel, Van, Geet, Tinto, Halidou and Jacobs, Jan (2014). Frequency of severe malaria and invasive bacterial infections among children admitted to a rural hospital in Burkina Faso. PLoS One,9(2 - Article No. e89103).

Document type: Journal Article
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IRMA ID 84473306xPUB28
Title Frequency of severe malaria and invasive bacterial infections among children admitted to a rural hospital in Burkina Faso
Author Maltha, Jessica
Guiraud, Issa
Kaboré, Bérenger
Lompo, Palpouguini
Ley, Benedikt
Bottieau, Emmanuel
Van, Geet
Tinto, Halidou
Jacobs, Jan
Journal Name PLoS One
Publication Date 2014
Volume Number 9
Issue Number 2 - Article No. e89103
ISSN 1932-6203   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84895893946
Total Pages 8
Place of Publication United States of America
Publisher Public Library of Science
HERDC Category C1 - Journal Article (DIISR)
Abstract Background: Although severe malaria is an important cause of mortality among children in Burkina Faso, data on community-acquired invasive bacterial infections (IBI, bacteremia and meningitis) are lacking, as well as data on the involved pathogens and their antibiotic resistance rates.

Methods: The present study was conducted in a rural hospital and health center in Burkina Faso, in a seasonal malaria transmission area. Hospitalized children (<15 years) presenting with T≥38.0°C and/or signs of severe illness were enrolled upon admission. Malaria diagnosis and blood culture were performed for all participants, lumbar puncture when clinically indicated. We assessed the frequency of severe malaria (microscopically confirmed, according to World Health Organization definitions) and IBI, and the species distribution and antibiotic resistance of the bacterial pathogens causing IBI.

Results: From July 2012 to July 2013, a total of 711 patients were included. Severe malaria was diagnosed in 292 (41.1%) children, including 8 (2.7%) with IBI co-infection. IBI was demonstrated in 67 (9.7%) children (bacteremia, n = 63; meningitis, n = 6), 8 (11.8%) were co-infected with malaria. Non-Typhoid Salmonella spp. (NTS) was the predominant isolate from blood culture (32.8%), followed by Salmonella Typhi (18.8%), Streptococcus pneumoniae (18.8%) and Escherichia coli (12.5%). High antibiotic resistance rates to first line antibiotics were observed, particularly among Gram-negative pathogens. In addition, decreased ciprofloxacin susceptibility and extended-spectrum beta lactamase (ESBL) production was reported for one NTS isolate each. ESBL production was observed in 3/8 E. coli isolates. In-hospital mortality was 8.2% and case-fatality rates for IBI (23.4%) were significantly higher compared to severe malaria (6.8%, p<0.001).

Conclusions: Although severe malaria was the main cause of illness, IBI were not uncommon and had higher case-fatality rates. The high frequency, antibiotic resistance rates and mortality rates of community acquired IBI require improvement in hygiene, better diagnostic methods and revision of current treatment guidelines.
DOI http://dx.doi.org/10.1371/journal.pone.0089103   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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