Researchers have found that children who develop acute kidney injury during severe malaria face an increased risk of death even after recovering from the illness and being discharged from hospital.
This follows a long-term study conducted jointly by researchers at Makerere University and Indiana University School of Medicine to, among other things, assess how kidney injury affects survival and progression to chronic kidney disease among children hospitalized with malaria.
The study found that more children who suffered kidney injury died than their counterparts who had malaria but whose kidneys were not affected. Dr Andrea Conroy, a Professor of Pediatrics at Indiana University School of Medicine, said those who got kidney injury were found to be at three times higher risk of death long after a malaria episode.
The study involved more than a thousand children aged between six months and twelve years admitted at different health facilities in Uganda with severe malaria. Speaking to URN in an interview on Thursday, Dr Anthony Batte, a Pediatric Nephrologist at the Child Health and Development Center of Makerere University, said four in every ten children who were admitted had their kidneys mildly reduced.
Ten percent of them developed severe injury, and as a result, five of them underwent a kidney transplant. Batte says one of the affected children had their transplant procedure conducted at Mulago National Referral Hospital. The researchers shared their findings after a recent death due to complications resulting from malaria of a student at Gayaza High School sparked debate on not just how complicated malaria can get but also the readiness of the health system to handle such cases.
Batte says that while the recent incidents of malaria in Kampala Secondary Schools caused widespread concern, their studies, which have been ongoing for more than fifteen years, have been picking up severe cases of malaria even in Kampala, where national statistics show the disease had largely been defeated.
He warns that malaria precautionary measures, such as the use of bed nets, should be seriously implemented in the country irrespective of whether one lives in a high-prevalence or low prevalence area. While sharing more findings from the study, Dr Conroy said more children who had also been treated with herbal medicines in combination with the conventional malaria treatments developed acute kidney injury.
The study involved a total of 1077 children, and findings have now been published in a medical journal, The Lancet Global Health. Meanwhile, malaria remains one of the leading causes of death among children below the age of five in Uganda with statistics by the Ministry of Health showing that prevalence in this age group remains high at about thirteen percent despite targeted treatment and prevention interventions in the age group over the years.
In all malaria cases that get admitted, kidney injury is a common occurrence, affecting up to sixty percent of them. The researchers recommend that children who suffer kidney injury should be followed up for a long time if they are to avert preventable deaths, since the study shows they may remain with complications more than two years after a malaria episode.
