Prevalence and factors associated with bacteremia among children with severe malaria Aged 2 to 59 months presenting at Hoima Regional Referral Hospital
Loading...
Date
2023-03
Authors
Dr. Zawadi Vulwaghe Gift
Journal Title
Journal ISSN
Volume Title
Publisher
Kampala International University
Abstract
Introduction
Bacteraemia is the presence of living bacterial organisms in circulating blood. Malaria-bacteraemia co-infection in children has 8.5-fold increased mortality compared to malaria alone. The objective of this study was to determine the prevalence, factors associated with bacteraemia, and the susceptibility patterns of bacterial isolates among children aged 2 to 59 months presenting with severe malaria at Hoima Regional Referral Hospital (HRRH).
Methods
This was a health facility-based cross-sectional analytical study at HRRH. The children diagnosed with severe malaria were enrolled and for each participant a blood sample was taken to determine the presence of bacteria. For children with bacteraemia, culture and antibiotic susceptibility were performed. Data were analyzed using SPSS 22.0.
Results
During the study period, 233 children had severe malaria out of which 228 children were enrolled. Of the 228 study participants, majority were males 139(61.0%), aged 2 to 30 months 174(76.3%). Bacterial growth was seen in 49 (21.5%) of the study participants. The factors that were independently associated with bacteraemia were: Not attaining formal education for the care taker (AOR=3.983,CI=1.078-7.720, P=0.038), undernutrition (AOR=6.231,CI=4.175-11.928, P<0.001), hypoglycemia (AOR=5.742, CI=2.157-7.283, P<0.001) and abnormal white cell count (AOR=2.341,CI=1.818-6.694, P=0.013). The most common isolate was salmonella Spp (32.6%), followed by staphylococcus Aureus (28.6%) and Klebsiella SPP (14.3%). All organisms were sensitive to Imipenem. Ampicillin and Benzathine Penicilline demonstrated only intermediate sensitivity to a few organisms.
Conclusion
The prevalence of bacteremia was high. The commonest bacteria isolated were salmonella Spp, staphylococcus Aureus, and Klebsiella SPP. There was high resistance to the commonly used antibiotics, but Imipenem demonstrated the highest level of sensitivity. Children presenting with severe malaria should be routinely screened for bacteremia paying more attention to those with undernutrition, those with hypoglycaemia and those with deranged white blood cell count.