Point-of-admission hypoglycaemia among under-five nigerian children with plasmodium falciparum malaria: Prevalence and risk factors

Background: Hypoglycaemia is a well recognized complication of falciparum malaria in children but its diagnosis may be overlooked because all the clinical features may mimic those of severe malaria.Objective: To determine the prevalence of hypoglycaemia at the point of hospital admission of under-fives with falciparum malaria and identify its risk factors in patients seen in a Nigerian secondary-health-care institution.Methods: At the point of admission, venous blood sample was collected into an appropriate sample bottle (fluoride oxalate bottle) from 502 children who were below 5 years old for malaria parasites (Giemsa stain). The blood sample was analysed for glucose using the glucose oxidase method. The time of last meal was noted.Results: Ninety two (18.3%) of 502 children with falciparum malaria had hypoglycaemia ( blood glucose below 2.6 mmol/L) at the point of hospital admission. Twenty three percent, 78 of 339 children below 36 months of age were hypoglycaemic compared to 8.6%, 14 of 163 children aged 36 months and above; p 0.01. Prevalence of hypoglycaemia was higher in girls than boys; 20.7% versus 16.3%, Odd ratio, OR = 1.3 (95% Confidence Interval, CI = 0.692-1.815). Forty of 305 children (13.1%) in whom the time of last meal was less than 12 hours had hypoglycaemia compared to 52 of 197 (26.4%) in whom the time of last meal was greater than 12 hours; p 0.05. The duration of illness and the degree of parasitaemia did not have significant bearing with the prevalence of hypoglycaemia.Conclusion: Hypoglycaemia do occur at point of hospital admission among under-fives with falciparum malaria, with age below 36 months and time of last meal greater than 12 hours being important risk factors. Routine monitoring of blood glu­cose at point of admission is suggested