Neuropaludism in Children: Clinical and Evolving Aspects in a Prefectoral Hospital in Guinea

Introduction: Cerebral malaria is one of the spontaneously fatal clinical manifestations of malaria. The aim of our study was to describe the clinical aspects and the evolving profile of cerebral malaria in children at the Coyah prefectural hospital. Material and methods: This was a prospective study of descriptive type over a period of 6 months from July 1st to December 31st, 2015. Our study was based on children admitted for severe malaria, presenting neurological signs and responding to our selection criteria. Results: 156 children were collected, with hospital frequency of 46%. The average age was 4.28 years old and the most affected age group was between 0 and 5 years (80.13%). The sex ratio=1.33; seizures and coma often preceded by fever were present in 51.92 and 23.72% respectively. Neuropaludism associated with anemia followed by cerebral malaria associated with hypoglycemia represented 52% and 26%, respectively, of the clinical phenotypes encountered in our study, while isolated cerebral malaria represented only 14%. 86.53% of patients had a favorable outcome, of which 76.27% presented no neurological abnormality on discharge and 10.26% with neurological sequelae on discharge from the hospital. 21 children or 13.47% died. Discussion: The delay in consultation in an adequate health structure linked on the one hand to the perception of modern medicine in rural areas and on the other hand to the epidemiological context of EBOLA virus hemorrhagic fever was aggravating causes of the diagnosis. Conclusion: Cerebral malaria is a major public health concern. The associated forms frequently observed lead to a fatal outcome because of the difficulties of care, especially in rural areas.