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To determine the risk factors for death from severe malaria in children in Burkina Faso, we conducted a retrospective case-control study covering a period of 24 months from January 2004 through December 2005, at the Charles de Gaulle Pediatric Hospital in Ouagadougou. Cases (n=72) were defined as all children hospitalized for and dying of confirmed severe malaria. The control subjects (n=72), matched for age, sex and date of hospitalization; were children hospitalized for confirmed severe malaria who were discharged after recovery. Risk factors assessed included: place of residence, socioeconomic level, self-medication, promptness of hospitalization, nutritional status, temperature and parasitemia. Case and control children were compared with pairwise tests. Low socioeconomic level (OR=5.4), late care (OR=15.5), poor nutritional status (OR=7.9) and a parasitemia greater than or equal to 5% (OR=2.8) were associated with a significant increase in the risk of death. In contrast, the malaria deaths were not associated with place of residence (OR=0.5), self-medication (OR=1) or fever of 41 degrees C or higher (OR=1.1). These results show the need for more health education to encourage early care-seeking in the event of fever, community-based interventions, and strengthening of the technical support centers for health facilities, as part of a national poverty reduction program.
Kouéta et al. (Thu,) studied this question.