Patterns of Severe Malaria among Patients Presented to Rufaa Pediatric Teaching Hospital, 2023

الملخص

Malaria remains one of the most serious public health challenges in Sudan, particularly among
children under five years of age. Despite the adoption of national malaria case management
protocols, adherence remains inconsistent, contributing to high morbidity and mortality. This
study aimed to investigate the patterns of severe malaria among pediatric patients presented to
Rufaa Pediatric Teaching Hospital in 2023. A descriptive hospital-based study was conducted
using structured data collection tools and patient records. Data collected were (287 samples).
The data was statistically analyzed using SPSS version 22. The majority of cases (81%)
occurred in children under five years of age and from rural areas (61%) and displaced
were(28%) which highlight young, rural, and displaced children are most at risk.. Fever was
the most common presenting feature (80%), followed by prostration (76%), pallor and
continuous vomiting (50%). Laboratory investigation was performed in 99% of cases, while
2.4% were diagnosed clinically, hemoglobin was performed in 167 children (58%), blood
glucose in only 25 children (9%), and renal function tests - serum urea and creatinine - in
3%,3% for each ,these figures highlight that essential investigation were missed and can affect
directly the outcome and increase the possibility of mortality. 57% of patients were treated
according to Sudan Malaria Case Management Protocol 2023 while 43% were not. Inpatient
treated children were 84%, outpatient treated children were 11%. Home treated children were
5% which represents a serious deviation from recommended practice. Full recovery was
achieved in 98.5%, while mortality was recorded in 1.1%, but gaps in treatment adherence and investigation uptake, highlighting how these gaps persist despite a low mortality rate. In
conclusion survival outcomes for pediatric severe malaria in Rufaa are favorable, but systemic
weaknesses threaten long-term progress. The study recommended strengthening adherence to
the Sudan malaria case management protocol (2023), improving diagnostic capacity to reduce
reliance on clinical judgment. Continuous training of healthcare providers, better monitoring
of treatment practices, and investment in laboratory infrastructure were also advised to reduce
morbidity and mortality among children.