CLINICAL OUTCOME OF COMPLICATED MALARIA AND ASSOCIATED FACTORS AMONG CHILDREN LESS THAN 5 YEARS DIAGNOSED WITH MALARIA AT WOLKITE UNIVERSITY COMPREHENSIVE SPECIALISED TEACHING AND REFERRAL HOSPITAL A RETROSPECTIVE STUDY.

Abstract

Background: Malaria is a major public health problem and a life-threatening parasitic infection, particularly among immunologically naive children who are highly vulnerable to severe complications. Objective: This study aimed to determine the clinical outcomes and factors associated with severe malaria among children under five diagnosed at WUCSRH in a retrospective study. Methods: An institution-based retrospective cross-sectional study was conducted by reviewing medical records and logbooks of children under five diagnosed with malaria. A total of 427 children were selected using systematic random sampling. Data were collected using a structured questionnaire, cleaned, coded, entered into SPSS, and analyzed using descriptive statistics and logistic regression. Results were presented in narrative form and tables. Results: Of the 427 children, 190 (44.5%) had severe malaria. The most frequent complications were severe anemia 114 (26.7%), seizures 40 (9.4%), prostration 20 (4.7%), cerebral malaria 10 (2.3%), acute kidney injury 4 (0.9%), and hypoglycemia 2 (0.5%). Treatment outcomes showed that 177 (41.9%) were discharged improved, 1 (0.2%) referred, 7 (1.6%) left against medical advice, and 3 (0.7%) died. Season of presentation, duration of illness, and patient residence were independently associated with severe malaria. Children presenting in spring had lower odds of severe malaria compared to summer (AOR = 0.23; 95% CI: 0.10–0.55). Delayed presentation of 2–7 days increased the risk of severe malaria (AOR = 44.62; 95% CI: 23.01–86.53; p < 0.001), while children living near the health acility had lower odds (AOR = 0.25; 95% CI: 0.11–0.57; p = 0.001). Conclusion: Severe malaria remains a significant cause of morbidity and mortality in children under five. Early healthcare seeking, improved access to health facilities, and preventive measures are essential to reduce its burden and improve outcomes in endemic areas