Blackwater fever in Congolese children: a report of clinical, laboratory features and risk factors

• Published in: Malaria journal Vol. 12; no. 1; p. 205
• Main Authors: Bodi, Joseph M, Nsibu, Célestin N, Longenge, Roland L, Aloni, Michel N, Akilimali, Pierre Z, Tshibassu, Pierre M, Kayembe, Patrick K, Omar, Ahmeddin H, Hirayama, Kenji, Verhaegen, Jan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.06.2013; BioMed Central
• Subjects: Acute renal failure; Adolescent; Age Distribution; Blackwater fever; Blackwater Fever - epidemiology; Blackwater Fever - pathology; Blood - parasitology; Blood Chemical Analysis; Case-Control Studies; Child; Child, Preschool; Complications and side effects; Democratic Republic of the Congo - epidemiology; Epidemiology; Expatriates; Female; Fever; Health facilities; Hemoglobin; Humans; Malaria; Malaria - complications; Male; Medical research; Medicine; Medicine, Experimental; Mortality; Pain; Plasmodium falciparum; Plasmodium falciparum - isolation & purification; Plasmodium malariae; Plasmodium malariae - isolation & purification; Quinine - therapeutic use; Risk Factors; Seasons; Sex Distribution; Studies; Urine - chemistry; Democratic Republic of the Congo; Congo (Kinshasa)
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/1475-2875-12-205

Blackwater fever (BWF) is one of the severe forms of malaria. This complication was first described among non-immune European expatriates in the malaria endemic areas. Recently, resurgence of this form of malaria has been reported among the indigenous populations. The objective of this study was to investigate the risk factors among BWF patients. A case-control study was conducted between in four hospitals located in Kinshasa, Democratic Republic of Congo from January 2010 to December 2011. One hundred and twenty nine children were recruited with 43 (cases) and 86 (control). No significant difference in the gender and age distribution was observed between the case and control). The sex-ratio male to female in the case group and control group was respectively 1:1.0 and 1:1.1. The mean age was 8.62 years (SD = 3.84) in patients with haemoglobinuria and 8.55 years (SD = 3.77) in the control group. No difference in frequency of co-infection with Plasmodium falciparum and Plasmodium malariae was observed between the two groups. Significant differences in haemoglobin, haematocrit, creatinine, urea and platelets levels were observed between the two groups (p < 0.001), but not for blood group and lactate dehydrogenase (LDH) level. Majority of the BWF cases occurred during the rainy season (88.4%). Treatment with quinine (95.3%) was significantly associated with cases (p < 0.001). Seven (16.2%) of the haemoglobinuric children developed acute renal failure. Rainy season, low parasitaemia and quinine ingestion were the major risk factors significantly associated with haemoglobinuria. Acute renal failure was observed as the major complication of BWF.