TITLE:
Malaria Retinopathy among Under-Five Children with Severe and Uncomplicated Malaria in a Tertiary Health Institution in Southwest Nigeria: A Comparative Study
AUTHORS:
Olusoji Omotayo Olayinka, Philip Olayele Abiodun, Tolulope Opeoluwa Jegede, Ifedayo Olabisi Fasoranti, Qasim Olakunle Salau, Abiodun John Kareem, Juliet Nnenda Olayinka, Evbenaye Stanley Obasohan, Babatunde David Babalola, Adeoye Adeleke Ademuyiwa, Foluwakemi Tope Ekogiawe, Ikechukwu Sunday Abazu, Emmanuel Olasunkanmi Babalola
KEYWORDS:
Children, Malaria, Nigeria, Ophthalmoscopy, Retinopathy
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.13 No.3,
July
31,
2023
ABSTRACT: Introduction: Malaria retinopathy refers to retinal abnormalities unique to malaria resulting from prolonged parasitization by Plasmodium falciparum. Identifying these features and treating them promptly could prevent lethal complications of malaria. Therefore, this study was conducted to identify and compare retinal findings in severe and uncomplicated malaria. Methods: A cross-sectional study of 260 subjects was equally divided into two groups of severe and uncomplicated malaria. Direct ophthalmoscopy was done at recruitment for all subjects. Information on sociodemographics, physical examination, nutritional status, and retinal abnormalities were recorded. A p-value Results: There were 141 (54.2%) males and 70 (26.9%) aged between 13 - 24 months. Severe anaemia, multiple convulsions, prostration, and cerebral malaria were the predominant forms of severe malaria. Twenty-three (17.7%) subjects with severe malaria and none with uncomplicated malaria had retinopathy. Retinal whitening (17.7%), vessel changes (16.2%), and retinal haemorrhages (5.4%) were the major forms of retinopathy. Retinopathy occurred in 43.8% of those with cerebral malaria. Retinal whitening and vessel changes were significantly associated with multiple convulsions, cerebral malaria, and metabolic acidosis; retinal haemorrhage was associated with cerebral malaria and haemoglobinuria (p = 0.022) and vessel changes with hypoglycaemia (p = 0.037). Cerebral malaria was an independent predictor of retinal whitening (p = 0.004) and vessel changes (p = 0.008) while haemoglobinuria was an independent predictor of retinal haemorrhages (p = 0.007). Conclusion: Ophthalmoscopy is an important examination in children with severe malaria which could assist in early detection and with prompt treatment, reduce morbidities and mortalities.