Investigating vital signs alteration within 24 hours of death in children with retinopathy positive cerebral malaria at Queen Elizabeth central hospital.
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Date
2021-08-04
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Kamuzu University of Health Sciences
Abstract
Executive Summary
Type of study: Retrospective, case-control study.
Problem: Malaria remains a major barrier to child health, development and survival. Malaria
causes high morbidity and mortality, especially in children below the age of 5. Overall, 90% of
death due falciparum malaria occurs in sub-Saharan Africa. Malawi is one of the malaria- endemic countries in sub-Saharan Africa, and has high prevalence rates of infection and high
mortality rates from the disease. Despite the Government of Malawi putting measures in place to
eradicate the disease, the country is still registering cases and deaths of malaria. Cerebral malaria
(CM) is a life threatening complication of severe malaria; the primary presenting symptom is
coma. The specificity of the clinical diagnosis is increased in children with evidence of malarial
retinopathy. Half of the deaths from CM occur within 24 hours of admission to hospital; the
overall condition of a patient is determined through monitoring of vital signs, and the aim, of this
study to determine whether changes in vital signs within 24 hours of death in children with
retinopathy positive cerebral malaria (RPCM) are predictors of mortality.
Objectives: To determine if changes in vital signs predict death in children with RPCM.
Methods: Baseline demographic and vital signs will be abstracted from existing case report
forms of 50 children who died with RPCM, and from 50 children with RPCM who survived. Data will be assessed using chi-squared test or Fishers exact test for categorical variables, one
way ANOVA will be used for normally distributed continuous variables and kruskal-wallis test
for continuous variables with skewed distributions with Tukey corrections for multiplicity.
Expected outcome and results dissemination plan: The study will provide data on alteration of
vital signs in children with CM. Recognizing vital sign changes prior to death from CM could
lead to more timely intensification of care of children with this pattern, and this in turn may helpto reduce the mortality rate associated with this clinical syndrome. I will write a report and send it
to College of Medicine Research Ethics Committee (COMREC) I will also present the results at
College of Medicine Research Ethics Committee (COMREC) Annual dissemination conference
and other relevant conferences and also submit manuscript(s) to peer-reviewed journals.
Furthermore the other report will be sent to Kamuzu College of Health sciences library, Blantyre
Malaria Project and at Queen Elizabeth Central Hospital Health Management Team.