Determinants of mortality in children aged 1-59 months hospitalised with malaria in Burkina Faso’ Sahel region: evidence from the Dori regional hospital centre
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Background Malaria remains a major cause of childhood mortality in sub-Saharan Africa, particularly in Burkina Faso’s Sahel region, where healthcare access is constrained by geographic, infrastructural, and security challenges. Data on in-hospital mortality determinants in this setting are limited. Methods We conducted a cross-sectional analytical study from August 1 to September 30, 2022, including all children aged 1–59 months hospitalized with laboratory-confirmed malaria at the Regional Hospital Centre of Dori. Socio-demographic, clinical, biological, and management variables were collected prospectively. Univariate and multivariate logistic regression were used to identify independent mortality determinants. Results Among 444 admitted children, the case-fatality rate was 14.4% (n = 64), with a median time to death of 5 days (IQR: 3–6). In multivariate analysis, significant mortality determinants included severe anemia (OR = 1.14, 95% CI: 1.06–1.24), no iron-folic acid supplementation (OR = 1.34, 1.26–1.43), respiratory distress (OR = 1.15, 1.08–1.23), hypoglycemia (OR = 1.13, 1.05–1.22), absence of blood transfusion (OR = 1.17, 1.07–1.27), altered consciousness (OR = 1.08, 1.02–1.15), state of shock (OR = 1.31, 1.13–1.52), no other adjuvant medicines (OR = 1.09, 1.02–1.18), convulsions (OR = 1.06, 1.00-1.12), transfer by ambulance (OR = 1.10, 1.02–1.18), parasite density > 100,000/µL (OR = 1.23, 1.01–1.50), and hemoglobinuria (OR = 1.26, 1.00-1.59). Conclusion The high pediatric malaria mortality in this Sahel setting is driven by both severe clinical presentations and gaps in supportive care. Improving early recognition of high-risk clinical features, ensuring timely access to blood transfusion, iron-folic acid, oxygen, and glucose, and strengthening referral systems should be prioritised to reduce deaths in similar high-burden, resource-limited contexts.
