Elsevier

The Lancet

Volume 329, Issue 8535, 28 March 1987, Pages 708-711
The Lancet

HYPOGLYCAEMIA IN AFRICAN CHILDREN WITH SEVERE MALARIA

https://doi.org/10.1016/S0140-6736(87)90354-0Get rights and content

Abstract

Hypoglycaemia, defined as a plasma glucose concentration below 2·2 mmol/l, developed in 15 of 47 prospectively studied Gambian children with severe chloroquine-sensitive falciparum malaria. 5 of these hypoglycaemic children died compared with 1 in the normoglycaemic group (p = 0·02). In contrast to previous observations in quinine-treated adults, in whom hypoglycaemia was associated with hyperinsulinaemia, plasma concentrations of insulin were appropriately low and plasma ketones were high. Raised plasma concentrations of lactate and alanine suggested impairment of hepatic gluconeogenesis. In African children, hypoglycaemia is an important and treatable manifestation of severe malaria and is unrelated to antimalarial treatment.

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