Malaria-Related Acute Kidney Injury in Adolescents and Young Adults in a Tertiary Hospital in the Gambia

Abstract

Background: Malaria is still an important public health problem in The Gambia, particularly in the adolescent and young adults (AYA). This study therefore assesses the clinical characteristics and outcome of malaria related AKI in AYA in The Gambia.
Method: This is a cross sectional retrospective descriptive study that reviewed records of admitted malaria patients in the Department of Internal Medicine, EFSTH, from October 18th2020 to February 2nd, 2022. A specific designed form was used to extract patients’ biodata, clinical features, referral facility, laboratory investigations, treatment, and outcome. STATA/SE 14.2 software was used for data analysis.
Results: The study included 163 malaria patients. Fifty patients (30.7%) had AKI. The mean age of patients with AKI was 26.5 years and majority were AYA 35 (70%). Most of the malaria patients with AKI were also male 31 (62%). The most common symptom in these patients was fever 47 (94%) and the most common sign was jaundice 26 (52%). Malaria patients with AKI had a lower haemoglobin level 9.7 (4.8-14) vs 11 (4.1-18.3), p value=0.001 compared to those without AKI. 14 (28%) AKI patients had haemodialysis. Male patients with AKI were more likely to have haemodialysis as compared to female patients 13 (92.9%):1 (7.2%) vs 18 (50%):18 (50%), p value=0.004. The total mortality amongst the patients with malaria-related AKI were 10 (20%). Patients with malaria related AKI were more likely to die as compared to malaria patients without AKI 10 (20%) vs 5(4.4%), p value=0.002.
Conclusion: This study has showed that malaria-related AKI is a significant problem in AYA in The Gambia and mortality is high. There is therefore a need for targeted interventions in this age group to help reduce morbidity and mortality related to malaria in The Gambia.