Prevalence of and factors associated with cerebral malaria among children aged 6 to 59 months with severe malaria in Western Uganda: A hospital-based cross-sectional study

Abstract Introduction Cerebral malaria, caused by Plasmodium falciparum, represents the most severe neurologic complication of malaria. Its association with high morbidity and mortality rates, especially among young children, underscores its clinical significance. In this study, we aimed to determine the prevalence of cerebral malaria and identify associated factors among children admitted with severe malaria at a tertiary hospital in western Uganda. Methods This was a cross-sectional, descriptive and analytical study involving children aged 6 to 59 months admitted with severe malaria. The study was conducted from January to March 2023 at Fort Portal Regional Referral Hospital. Severe and cerebral malaria were defined as per the WHO criteria. Sociodemographic, clinical and laboratory data were collected and analyzed using IBM SPSS version 27. Logistic regression analysis was used to evaluate the factors associated with cerebral malaria. A p value Results A total of 250 children were recruited (mean age 33.1±17.3 months). The prevalence of cerebral malaria was 12.8% (95% C. I: 8.9-17.6). Cerebral malaria was independently associated with male sex (aOR: 3.05, 95%C. I: 1.20-7.77, p=0.02), abnormal bleeding (aOR: 13.22, 95%C. I: 11.54-15.16, p=0.001), history of convulsions (aOR 12.20, 95% C. I:10.7, -21. 69, p= 0.010), acute kidney injury (aOR: 4.50, 95% C. I: 1.30-15.53, p=0.02), and hyponatremia (aOR: 3.47, 95% C. I: 1.34-8.96, p=0.010). Conclusions and recommendations The prevalence of cerebral malaria was high among children with severe malaria. Male sex, a history of convulsion, abnormal bleeding, acute kidney injury, and hyponatremia were associated with increased odds of cerebral malaria. These characteristics should be properly investigated and adequately treated in young children to reduce the risk and complications associated with cerebral malaria.