Prevalence and Factors Associated with Acute Kidney Injury among Malaria Patients in Dar es Salaam: A Cross-Sectional Study

Authors:

Mohamed Muhamedhussein
S. Ghosh
Khuzeima Khanbhai
Elizabeth Maganga
Z. Nagri
Mohamed Manji

Abstract:

Background: Falciparum malaria still remains as a major cause of morbidity and mortality worldwide. Acute kidney injury is a known complication of malaria, and it is reported to occur in up to % of adult patients with severe falciparum malaria in endemic regions like sub-Saharan Africa. Objectives. To determine the prevalence and factors associated with acute kidney injury among falciparum malaria patients in a tertiary level private hospital in Dar es Salaam.

Methodology. In a cross-sectional study design, adults with falciparum malaria were enrolled consecutively over months from April to September . The diagnosis of acute kidney injury (AKI) in these patients was established using the KDIGO classification criteria. the prevalence of AKI was obtained hours from admission and at day . Different sociodemographic and clinical parameters which were associated with acute kidney injury at hours and at day were identified by hypothesis testing using chi squared tests followed by multivariate logistic regression analysis. Factors with a p value less than . were considered significant.

Results: participants were predominantly males .% (/) and a third (.% (/)) were between and years. the prevalence of AKI among malaria patients at hours was % (/). the prevalence of AKI among malaria patients at day was .% (/). On multivariate logistic regression, we found that factors that were significantly associated with AKI at hours were male sex (OR , CI .–, P =.) and hemoglobin <.g/dl (OR ., CI .–., P = .), and the factor associated with AKI at day was baseline platelet count <×3 per mm3(OR . CI .–., P = .). Only two patients needed hemodialysis (.%) and there were no deaths.

Conclusion. Acute kidney injury is a common complication in patient with falciparum malaria. When managed well it has an excellent prognosis and necessitates dialysis in only a minority of patients. Male sex and hemoglobin is associated with AKI at hours and baseline platelet count is associated with AKI at days