Neurological Complications Associated with Severe Malaria at the Albert Royer National Children’s Hospital, Dakar, Senegal

Introduction: Neurological complications associated with severe malaria constitute a medical emergency with high morbidity and mortality. The objective of our study was to determine their epidemiological, clinical, paraclinical, and therapeutic aspects. Methodology: This was a retrospective, descriptive, and analytical study conducted at Albert Royer National Children’s Hospital in Dakar from January 1, 2021 to December 31, 2022. Results: We included 53 patients, of whom 32 were male. The mean age was 5.64 years, ranging from 7 months to 15 years. Thirty-nine patients (73.6%) were from Dakar and 26.4% from other regions. Only 9 patients used long-lasting mosquito bed nets, and all resided in the region of Dakar. The mean consultation time was 3.8 days. Prostration was the most common neurological sign (41.5%), followed by seizures (35.8%). We observed anemia in 47 patients (90%), hyperleukocytosis in 32 patients (60.4%) and thrombocytopenia in 29 patients (54.7%). Eight patients (31.4%) had renal failure with a mean glomerular filtration rate of 94.31 ml/min/1.73m2. For the parasitological diagnosis of malaria, the rapid diagnostic test was positive in 50 patients (94.33%) and the thick blood smear was positive in all patients, with a mean parasite density of 15,288 p/ml. All children were hospitalized for a mean duration of 7 days and injectable artesunate was the most used molecule (94.3%). The outcome was favorable in 43 patients (81%), with complete recovery, and 10 children (19%) died. We did not find a statistically significant p-value explaining risk of death. Conclusion: Neurological complications of severe malaria require early and appropriate management to reduce morbidity and mortality.