High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda

Peter Olupot- Olupot; Charles Engoru; Sophie Uyoga; Rita Muhindo; Alex Macharia; Sarah Kiguli; Robert Opoka; Samuel Akech; Carolyne Ndila; Richard Nyeko; George Mtove; Julius Nteziyaremye; Martin Chebet; Elizabeth C. George; Abdel G. Babiker; Diana M. Gibb; Thomas N. Williams; Kathryn Maitland

doi:10.1093/cid/cix003

High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda

Peter Olupot- Olupot, Charles Engoru, Sophie Uyoga, Rita Muhindo, Alex Macharia, Sarah Kiguli, Robert Opoka, Samuel Akech, Carolyne Ndila, Richard Nyeko, George Mtove, Julius Nteziyaremye, Martin Chebet, Elizabeth C. George, Abdel G. Babiker, Diana M. Gibb, Thomas N. Williams, Kathryn Maitland

Medical College, East Africa

Research output: Contribution to journal › Article

37 Citations (Scopus)

Abstract

Background.

In the Fluid Expansion as a Supportive Treatment (FEAST) trial, an unexpectedly high proportion of participants from eastern Uganda presented with blackwater fever (BWF).

Methods.

We describe the prevalence and outcome of BWF among trial participants and compare the prevalence of 3 malar- ia-protective red blood cell polymorphisms in BWF cases vs both trial (non-BWF) and population controls. Results. Of 3170 trial participants, 394 (12.4%) had BWF. The majority (318 [81.0%]) presented in eastern Uganda and were the subjects of further analysis. BWF cases typically presented with both clinical jaundice (254/318 [80%]) and severe anemia (hemoglo- bin level

Conclusions.

We report the emergence of BWF in eastern Uganda, a condition that, according to local investigators, was rare until the last 7 years. We speculate that this might relate to the introduction of artemisinin-based combination therapies. Further studies investigating this possibility are urgently required.

Original language	Undefined/Unknown
Journal	Paediatrics and Child Health, East Africa
DOIs	https://doi.org/10.1093/cid/cix003
Publication status	Published - 1 Apr 2017

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10.1093/cid/cix003Licence: Unspecified

http://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/441

Cite this

Olupot, P. O., Engoru, C., Uyoga, S., Muhindo, R., Macharia, A., Kiguli, S., Opoka, R., Akech, S., Ndila, C., Nyeko, R., Mtove, G., Nteziyaremye, J., Chebet, M., George, E. C., Babiker, A. G., Gibb, D. M., Williams, T. N., & Maitland, K. (2017). High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda. Paediatrics and Child Health, East Africa. https://doi.org/10.1093/cid/cix003

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abstract = "Background. In the Fluid Expansion as a Supportive Treatment (FEAST) trial, an unexpectedly high proportion of participants from eastern Uganda presented with blackwater fever (BWF). Methods. We describe the prevalence and outcome of BWF among trial participants and compare the prevalence of 3 malar- ia-protective red blood cell polymorphisms in BWF cases vs both trial (non-BWF) and population controls. Results. Of 3170 trial participants, 394 (12.4%) had BWF. The majority (318 [81.0%]) presented in eastern Uganda and were the subjects of further analysis. BWF cases typically presented with both clinical jaundice (254/318 [80%]) and severe anemia (hemoglo- bin level Conclusions. We report the emergence of BWF in eastern Uganda, a condition that, according to local investigators, was rare until the last 7 years. We speculate that this might relate to the introduction of artemisinin-based combination therapies. Further studies investigating this possibility are urgently required.",

author = "Olupot, {Peter Olupot-} and Charles Engoru and Sophie Uyoga and Rita Muhindo and Alex Macharia and Sarah Kiguli and Robert Opoka and Samuel Akech and Carolyne Ndila and Richard Nyeko and George Mtove and Julius Nteziyaremye and Martin Chebet and George, {Elizabeth C.} and Babiker, {Abdel G.} and Gibb, {Diana M.} and Williams, {Thomas N.} and Kathryn Maitland",

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journal = "Paediatrics and Child Health, East Africa",

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Olupot, PO, Engoru, C, Uyoga, S, Muhindo, R, Macharia, A, Kiguli, S, Opoka, R, Akech, S, Ndila, C, Nyeko, R, Mtove, G, Nteziyaremye, J, Chebet, M, George, EC, Babiker, AG, Gibb, DM, Williams, TN & Maitland, K 2017, 'High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda', Paediatrics and Child Health, East Africa. https://doi.org/10.1093/cid/cix003

TY - JOUR

T1 - High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda

AU - Olupot, Peter Olupot-

AU - Engoru, Charles

AU - Uyoga, Sophie

AU - Muhindo, Rita

AU - Macharia, Alex

AU - Kiguli, Sarah

AU - Opoka, Robert

AU - Akech, Samuel

AU - Ndila, Carolyne

AU - Nyeko, Richard

AU - Mtove, George

AU - Nteziyaremye, Julius

AU - Chebet, Martin

AU - George, Elizabeth C.

AU - Babiker, Abdel G.

AU - Gibb, Diana M.

AU - Williams, Thomas N.

AU - Maitland, Kathryn

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background. In the Fluid Expansion as a Supportive Treatment (FEAST) trial, an unexpectedly high proportion of participants from eastern Uganda presented with blackwater fever (BWF). Methods. We describe the prevalence and outcome of BWF among trial participants and compare the prevalence of 3 malar- ia-protective red blood cell polymorphisms in BWF cases vs both trial (non-BWF) and population controls. Results. Of 3170 trial participants, 394 (12.4%) had BWF. The majority (318 [81.0%]) presented in eastern Uganda and were the subjects of further analysis. BWF cases typically presented with both clinical jaundice (254/318 [80%]) and severe anemia (hemoglo- bin level Conclusions. We report the emergence of BWF in eastern Uganda, a condition that, according to local investigators, was rare until the last 7 years. We speculate that this might relate to the introduction of artemisinin-based combination therapies. Further studies investigating this possibility are urgently required.

AB - Background. In the Fluid Expansion as a Supportive Treatment (FEAST) trial, an unexpectedly high proportion of participants from eastern Uganda presented with blackwater fever (BWF). Methods. We describe the prevalence and outcome of BWF among trial participants and compare the prevalence of 3 malar- ia-protective red blood cell polymorphisms in BWF cases vs both trial (non-BWF) and population controls. Results. Of 3170 trial participants, 394 (12.4%) had BWF. The majority (318 [81.0%]) presented in eastern Uganda and were the subjects of further analysis. BWF cases typically presented with both clinical jaundice (254/318 [80%]) and severe anemia (hemoglo- bin level Conclusions. We report the emergence of BWF in eastern Uganda, a condition that, according to local investigators, was rare until the last 7 years. We speculate that this might relate to the introduction of artemisinin-based combination therapies. Further studies investigating this possibility are urgently required.

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DO - 10.1093/cid/cix003

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JO - Paediatrics and Child Health, East Africa

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