Effectiveness of Severe Neurological Malaria Case Management at Bolenge General Referral Hospital, Democratic Republic of Congo: A Retrospective Cohort Study
Abstract
Background
Severe neurological malaria (cerebral malaria) remains a major public health threat in the Democratic Republic of the Congo (DRC), particularly among children under five years of age. This study evaluated the effectiveness of severe neurological malaria case management at Bolenge General Referral Hospital (HGR Bolenge).
Methods
A retrospective descriptive and analytical cohort study was conducted on 80 patient records of individuals admitted with severe neurological malaria to HGR Bolenge between August and December 2025. Data were collected using a standardized extraction form. Sociodemographic, clinical, therapeutic, and outcome data were analyzed using Excel and SPSS. Univariate, bivariate (chi-square), and multivariate (logistic regression) analyses were performed.
Results
Children aged 0–5 years accounted for 47.5% of cases, with male predominance (56.3%). The most frequent clinical signs were high fever (92.5%), convulsions (65.0%), and coma (50.0%). Injectable artesunate was administered to 72.5% of patients. The overall recovery rate was 75.0%, with 15.0% developing complications and 10.0% dying. Early consultation (<24 hours) and artesunate use were significantly associated with favorable outcomes (p=0.01 and p=0.02, respectively). Multivariate analysis identified early consultation (aOR=3.8; 95% CI: 1.4–10.2; p=0.008) and artesunate treatment (aOR=4.2; 95% CI: 1.5–11.5; p=0.005) as independent predictors of recovery, while coma predicted poor prognosis (aOR=0.4; 95% CI: 0.1–0.9; p=0.031).
Conclusions
The effectiveness of severe neurological malaria management at HGR Bolenge is significantly influenced by timeliness of consultation and choice of antimalarial therapy. Injectable artesunate demonstrated superior efficacy compared to quinine. A mortality rate of 10% remains concerning, highlighting the need for improved early diagnosis, prompt referral systems, and strengthened neurological monitoring protocols.
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How to cite
Befulu Liyena, A. (2026). Effectiveness of Severe Neurological Malaria Case Management at Bolenge General Referral Hospital, Democratic Republic of Congo: A Retrospective Cohort Study. SDF Journal of Public Health. https://sfoundation.one/articles/sdf-2026-0041-effectiveness-of-severe-neurological-malaria-case-management-at-boleng