Kidney Function in Children with Severe Malaria Seen at the University of Ilorin Teaching Hospital, Ilorin

Background: Malaria is the leading cause of hospital admission in Africa and constitutes the greatest disease burden in the region. More than one hundred nations are affected worldwide with children and pregnant women being mostly vulnerable. Children under the age of five years suffer severe forms.  Malaria is said to be severe when the acute illness is associated with a life-threatening event(s). Several organ systems including the kidney can be involved. In most cases, severe malaria if untreated tends to result in Acute kidney injury. Therefore, the objective of this study is to examine kidney function in children with severe malaria seen at the University of Ilorin Teaching Hospital (UITH), Ilorin. A prospective case-control study was conducted in the Emergency Paediatrics Unit (EPU), the Children’s ward, and the General Outpatient Department (GOPD) of the UITH over one year. A total of 164 children were recruited into the study, of which 82 had severe malaria served as subjects and 82 with uncomplicated malaria served as controls. The male-to-female ratio was 1:1 in the subjects and 1.4:1 in the controls. The median age was 36.0 months in the subjects and 36.0 months in the controls, both groups were comparable (p ＞ 0.05). Children between the ages of 1 to 5 years constituted 62.2% of the entire population studied. The estimated Glomerular Filtration Rate (eGFR) in children with severe malaria was compromised in 30% of cases. Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria; an increase in serum creatinine value of 0.3 mg/dl (5.4 mmol/l) within 48 hours of admission was applied. Correspondingly the serum urea and creatinine were compromised in the same group of patients. The prevalence of acute AKI in this study was 30.5%. The mean eGFR, potassium, sodium, urea, and creatinine at admission were 74.6 ± 56.3 ml/min/1.73m2, 5.4 ± 0.5 mmol/l, 143.9 ± 12.3 mmol/l, 117.2 ± 27.5 μmol/l and 6.3 ± 5.6 mmol/l respectively. Outside sodium, these parameters were higher in subjects than in controls.