HEMOLYTIC UREMIC SYNDROME (HUS) INSEVERE MALARIA DUE TO PLASMODIUM FALCIPARUM ANDPLASMODIUM MALARIAE AMONG PATIENTS ADMITTED TO THE NATIONAL HOSPITAL OF ZINDER(NIGER)

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Abstract Title *

HEMOLYTIC UREMIC SYNDROME (HUS) INSEVERE MALARIA DUE TO PLASMODIUM FALCIPARUM ANDPLASMODIUM MALARIAE AMONG PATIENTS ADMITTED TO THE NATIONAL HOSPITAL OF ZINDER(NIGER)

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Co-author 1

Hassane MOUSSA DIONGOLE hassane.moussadiongole@uas.edu.ne Andre Salifou University/ Faculty of Health Sciences Midecine Zinder Niger *

Co-author 2

Moustapha LAMINE MAHAMAN lamine.moustapha@uas.uas.edu.ne Andre Salifou University/Faculty of Sciences and Technology Microbiology Zinder Niger -

Co-author 3

Imelda Shannon KOUNDOU NTUE imeldakoundou6@gmail.com National Hospital Nephrology Zinder Niger -

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Introduction

Hemolytic Uremic Syndrome (HUS) is a rare but serious complication of malaria, and its occurrence remains poorly documented in this context. This study aimed to describe the clinical and biological manifestations of HUS in cases of severe malaria.

Methods

A cross-sectional study was conducted during the high malaria transmission season, including hospitalized patients with severe malaria and suspected HUS. Data were collected using standardized forms and analyzed with XLSTAT2025.

Results

Among the 38 patients enrolled, 21 were confirmed to have HUS (55.26%). The mean age of these 21 patients was 13 ± 11.65 years. Clinical findings included oliguria or anuria in 76.19% (16/21), altered consciousness in 66.66% (14/21), hyperthermia in 95.23% (20/21), and hemorrhagic signs in 9.52% (2/21). Laboratory findings revealed low levels of hemoglobin (5.96 ± 0.07 g/dL) and platelets (63.90 ± 33.96 × 10³/mm³), along with elevated mean values of serum creatinine (594.04 ± 393.21 µmol/L), potassium (5.32 ± 1.32 mmol/L), and schizocytes (3.7%). Plasmodium falciparum was detected in all cases, while 38.9% (8/21) had a co-infection with Plasmodium malariae. All patients received treatment with injectable artemisinin derivatives, and 28.57% (6/21) underwent dialysis. The mortality rate was 14.28% (3/21). A statistically significant association was found between the presence of hemorrhagic signs (p = 0.009; OR = 0.11), as well as between hyperkalemia and the occurrence of HUS (p = 0.04; OR = 5.62).

Conclusion

HUS should be suspected in cases of abnormal bleeding and hyperkalemia during severe malaria and confirmed by blood smear examination.

Kewords