Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Acute Kidney Damage during Severe Malaria in Children at the Borgou Departmental Teaching Hospital (Benin)

Main Article Content

Séraphin Ahoui
Alphonse Noudamadjo
Gerard Kpanidja
Evariste Eteka
K.O. Auguste Akoto
Falilatou Agbeille
Muriel Toutche
Aristide Dah
Julien Didier Adedemy
Joseph Agossou

Keywords

children, kidney disease, malaria, predictors, Parakou

Abstract

Malaria is an endemic pathology with several complications, including kidney damage. The objective of this work was to study kidney damage during severe malaria in children at the pediatrics department of the Borgou Departmental Teaching Hospital (Borgou DTH), Benin in 2021. This was a longitudinal study carried out over 4 months from June 1, 2021 to September 30, 2021 (with 1 month of recruitment from June 1 to July 1, 2021) at the pediatric department of the Borgou DTH. The study included children aged 1 month–15 years, hospitalized for Plasmodium falciparum malaria with at least one clinical manifestation of malaria severity established by the World Health Organization in 2000 and whose parents had given their informed consent. The damage was established by urinary sedimentation using urine dipstick and urinary cap and serum creatinine. Acute kidney injury (AKI) was intended and classified according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The dependent variable was the presence of at least one clinical, biological, and functional impairment. Follow-up was regular for up to 3 months. Lost to follow-up were excluded. Predictors of occurrence were identified. Statistical difference was considered significant at P < 0.05. Of the 164 children hospitalized for severe malaria during the study period, 72 had at least one renal impairment, with a frequency of 43.90%. The average age of the children was 44.93 months. On urine dipstick, 76.39% of the patients had hemoglobinuria and 55.56% had albuminuria. Urinary cap revealed 44% granular cylindruria and 32% crystalluria. AKI was detected in 4.54% patients. Recovery was complete in all follow-up cases. The predictors of kidney damage were coma ( P = 0.017), jaundice ( P = 0.007), thrombocytopenia ( P = 0.021), and long hospital stay ( P = 0.008). Kidney damage in severe malaria is frequent. Early diagnosis and prompt treatment are fundamentals of rapid and complete recovery of kidney functions.

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References

1. World Health Organization (WHO). World malaria report 2020: 20 Years of global progress and challenges. Geneva, Switzerland: WHO; 2020.

2. Enquêtes Démographiques et de Santé. Résultats d’un atelier de l’utilisation des données des Enquêtes Démographiques et de Santé [Internet]. [cited 2020 Nov 14]. Rockville, MD: ICF; Sep 2020. Available from: www.Dhsprogram.com.

3. Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: Severe malaria. Crit Care. 2003;7(4):315–23. 10.1186/cc2183

4. Elsheikha HM, Sheashaa HA. Epidemiology, pathophysiology, management and outcome of renal dysfunction associated with plasmodia infection. Parasitol Res. 2007;101(5):1183–90. 10.1007/s00436-007-0650-4

5. Eiam-Ong S, Sitprija V. Falciparum malaria and the kidney: A model of inflammation. Am J Kidney Dis. 1998;32(3):361–75. 10.1053/ajkd.1998.v32.pm9740151

6. Kamath N, Iyengar A. Infections and the kidney: A tale from the tropics. Pediatr Nephrol. 2018;33(8):1317–26. 10.1007/s00467-017-3785-2

7. Lalya F, Sagbo G, Bagnan L, Alihonou F, Tohodjede Y, Almeida M, et al. L’insuffisance rénale aiguë associée au paludisme chez l’enfant au Centre National Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou, Benin. Rev Afr Anesth Med Urgence. 2014;19(1):39–42.

8. Gachot B, Bruneel F, Berth C. Paludisme grave. Revue du Praticien. 2001;51(6):638–43. 10.1016/s0246-0289(09)50990-5

9. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Inter Suppl. 2012;2(1):1–138. 10.1038/kisup.2012.1

10. Kéita Y, Cissé M, Sylla A, Ly F, Boiro D, Ndongo A, et al. La néphropathie liée au paludisme grave à plasmodium falciparum chez l’ enfant dans deux services pédiatriques universitaires sénégalais : à propos de 79 cas. J Afr Pediatr Genet Med. 2017;3:38-43.

11. Oshomah-bello E, Paed F, Esezobor C, Paed F, Solarin A, Paed F, et al. Acute kidney injury in children with severe malaria is common and associated with adverse hospital outcomes. J Trop Pediat. 2019:66(2):1–8. 10.1093/tropej/fmz057

12. Afolayan F, Adedoyin O, Abdulkadir M, Ibrahim O, Biliaminu S, Mokuolu O, et al. Acute kidney injuries in children with severe malaria a comparative study of diagnostic criteria based on serum cystatin C and creatinine levels. Sultan Qaboos Univ Med J (SQUMJ). 2020;20(4):e312–7. 10.18295/squmj.2020.20.04.006

13. Esezobor C, Ladapo T, Osinaike B, Ebun F, Lesi A. Paediatric acute kidney injury in a tertiary hospital in Nigeria : Prevalence, causes and mortality rate. Plos One. 2012;7(12):1–6. 10.1371/journal.pone.0051229

14. Moussa Tondi Z, Moussa H, Garba M, Abdou I, Salamatou N, Soumeila I, et al. Insuffisance rénale aiguë au cours du paludisme grave de l’enfant : expérience des services de pédiatrie des hôpitaux de la ville de Niamey (Niger). Néphrologie Thérapeutique. 2017;13(5):361–2. 10.1016/j.nephro.2017.08.221

15. Ephraim R, Adoba P, Sakyi S, Aporeigah J, Fondjo L, Botchway F, et al. Acute kidney injury in pediatric patients with malaria: A prospective cross-sectional study in the Shai-Osudoku District of Ghana. Saudi J Kidney Dis Transplant. 2020;31(1):235–44. 10.4103/1319-2442.279946

16. Essola L, Mowangue PS, Minko J, Soami V, Sima ZA, Ngomas JF. Prise en Charge de l’insuffisance rénale aiguë dans le Paludisme Grave de l’Enfant au centre Hospitalier Universitaire de Libreville. Une Étude de 12 Cas. Health Sci Dis. 2019;20(4):57–61. Retrieved from https://www.hsd-fmsb.org/index.php/hsd/article/view/1475

17. Shah P, Vanikar A, Kasat P, Gumber M, Trivedi H, Rasiklal Doshi G, et al. Malaria induced acute renal failure: A single center experience. Saudi J Kidney Dis Transplant. 2010;21(6):1088–91. PMid: 21060178.

18. Zaki S, Shenoy P, Shanbag P, Mauskar A, Patil A, Nagotkar L. Acute renal failure associated with malaria in children. Saudi J Kidney Dis Transpl. 2013;24(2):303–8. 10.4103/1319-2442.109585

19. Van Slambrouck C, Salem F, Meehan S, Chang A. Bile cast nephropathy is a common pathologic finding for kidney injury associated with severe liver dysfunction. Kidney Int. 2013;84(1):192–97. https://pubmed.ncbi.nlm.nih.gov/23486516/

20. World Health Organization (WHO). Severe malaria. Trop Med Int Health. 2014;19:7–131. 10.1111/tmi.12313_2

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