Abstract
BACKGROUND: For thousands of years, humans have been plagued by the deadly disease malaria, affecting millions of people and harming their physical, social, and economic well-being. Despite significant progress over the past two decades in reducing malaria-related morbidity and mortality, malaria remains a major public health threat, particularly in Ethiopia. It is important to assess the treatment outcome of severe malaria and the factors influencing them due to the high prevalence and epidemic nature of the disease in the Gambella region of Ethiopia. METHODS: An institution-based retrospective study was conducted at Gambella General Hospital among 417 children aged from one month to fourteen years who were admitted with severe malaria between May 2022 to May 2024. Data were collected using pre-tested data collection forms. The collected data were cleaned and entered into EPIData, which was again exported into statistical software for analysis. Bivariate and multivariable logistic regression analyses were used to determine associations between determinants and the outcome variable. A significance level was set at p < 0.25 and p < 0.05 for bivariate and multivariable logistic regression, respectively. RESULTS: Of 417 children enrolled in the study, the mean age was 4.03 years (SD of ± 2.11 years). The overall case fatality rate for severe malaria was 9.11%. High case fatality rates were also observed among children presenting with severe anemia 31.8%, convulsions 27%, pulmonary edema 19.7%, Coma 18.5%, acute kidney injury 18.4%, and comorbid illnesses 16.9%. The majority of the children (91.7%) admitted to the hospital had Plasmodium falciparum, which accounted for 34 (89.5%) of the deaths. Among the predictor variables assessed, convulsion, severe anemia, and comorbid illnesses were significantly associated with the outcome. CONCLUSION: In this study, the overall case fatality rate of severe malaria in children was notably high. This underscores the pressing necessity of prioritizing intervention packages that include preventive strategies, early detection, and the prompt identification of features that indicate severity.