Omolola Mojisola Atalabi MBBS, Presenter: Nothing to Disclose

Adebola Orimadegun MBBS, Abstract Co-Author: Nothing to Disclose

Ademola Joseph Adekanmi MBBCh, Abstract Co-Author: Nothing to Disclose

Eric Okechukwu Umeh MBBS, Abstract Co-Author: Nothing to Disclose

Temitope Oluwatosin Soyemi MBBS, Abstract Co-Author: Nothing to Disclose

Plasmodium falciparum malaria, a major cause of morbidity in children may affect kidneys leading to tubulointerstitial damage and glomerulonephritis. The purpose of this study was to describe the renal ultrasonographic findings associated with acute malaria among Nigerian children.

In a case control study, children with microscopically confirmed falciparum malaria infection seen at the University College Hospital, Ibadan over a period of 6months were systematically selected. Children with WHO-defined Severe Malaria (SM, n=16) were cases while Uncomplicated Malaria (UM, n=16) were control group (age-matched).All participants were screened for renal abnormalities at presentation using portable ultrasound units with Doppler facility. Main outcome variables were kidney volume and indices of renal blood flow. Comparisons were made between SM and UM. Level of significance was set at p=0.05.

Participants were aged 7 to 112 months, mean age of 58.6±31.8 months and 24 were male. Comparing SM versus UM; mean kidney volumes were 64.8±31.5mm3 versus 45.9±16.1mm3 for the left (p=0.046) and 65.7±24.5mm3 versus 48.9±17.6mm3 for the right (p<0.05). Blood flow volume for main renal artery was lower in SM than UM with mean main arterial flows of 67.8±28.1 versus 100.6±25.2 for left kidney (p<0.05) and 94.2±52.1 versus 94.9±22.2 for right (p<0.05), but no difference in the mean width of main arteries and veins in both kidneys. The RI and PI did not show any significant difference. EDV was significantly lower in SM than UM in all the three poles of the kidneys (p<0.05). Mean PSV in right kidneys were significantly lower in upper pole among SM (39.0±20.2) than UM (57.6±20.6); and the lower pole among SM (35.2±17.1) than UM (51.2±20.1)

Children with severe malaria demonstrated increased in renal volume and blood flow than uncomplicated malaria especially in the right kidney. These findings call attention to the need for the use of ultrasonography in diagnostic and prognostic evaluation of malaria in children.

Ultrasonography has the potential to detect early renal changes in children with Severe Malaria, thus allowing for early and appropriate treatment and follow up in a low socioeconomic setting.

Atalabi, O, Orimadegun, A, Adekanmi, A, Umeh, E, Soyemi, T, Ultrasonography in the Assessment of Renal Status during Malarial Illness among Nigerian Children: Preliminary Findings.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034234.html