A Case Series: A Mother and Daughter with a Critically Low Hemoglobin Level Resulting from Severe Anemia Secondary to Malaria

Abstract

Background

Malaria can lead to anemia, a condition marked by a reduction in red blood cells or lower than typical levels of hemoglobin. This condition mainly affects women and children and, in severe cases, can hinder the cognitive and motor development of children. It also poses significant risks for pregnant women and their unborn children.

Case presentation

An 18-month-old girl and her mother, referred from conflict-affected West Wollega, Ethiopia due to severe malaria, were admitted to Assosa General Hospital, Ethiopia, with critical health indicators. The daughter (case 1) had a hemoglobin level of 0.8 g/dL, a red blood cell count of 0.44 × 10^6u/L, an oxygen saturation of 90%, a body temperature of 36.6 °C, a heartbeat of 132 beats per minute, and a respiratory rate of 48 breaths per minute. She displayed signs of pale conjunctivitis and severe palmar paleness, and weighed 7 kg. The mother(case 2), aged 35, also had a history of severe malaria and presented with a critically low hemoglobin level of 2.5g/dL and a red blood cell count of 0.75 × 10^6u/L, with an oxygen saturation of 89%. Blood transfusion and malaria treatment were administered, and by the end of their hospital stay, both cases’ symptoms had resolved, and they returned to normal baseline vital signs, including their hemoglobin levels.

Conclusions

Severely low hemoglobin levels, worsened by severe malaria, present a significant danger in cases of anemia. As far as I am aware, this might be the lowest hemoglobin level recorded. Promoting awareness, economic empowerment initiatives, alongside routine provision of iron supplements and Prompt malaria diagnosis and treatment to create a comprehensive approach that addresses the multifaceted challenges posed by anemia, ultimately leading to improved health outcomes for vulnerable populations.

Keywords:

• hemoglobin
• anemia
• malaria
• case series

Abbreviations

WHO, World Health Organization; BGRS, Benishangul Gumuz regional state; MOH, Ministry of Health, EPHI, Ethiopian Public Health Institute; RHB, Regional Health Bureau; ICU, Intensive Care Unit; mmHg, millimeter of mercury, bpm, breath per minutes, beat per minutes(bpm), CBC, complete blood count, ESR erythrocyte sedimentation rate, RBC, red blood cell; hemoglobin; MUAC, mid-upper arm circumference, dl deciliter, ICRC, International Committee of the Red Cross.

Ethical Considerations

The study was carried out in accordance with the principles of the Declaration of Helsinki. A formal letter of permission has been obtained from Assosa general hospital management bodies; the study did adversely not affect the rights and welfare of the human.

Consent for Publication

The father of the daughter and the mother’s provided consent for the publication and use of data in research. The report does not contain any information that could lead to the patient’s identification.

Acknowledgment

The cooperation of Assosa General Hospital quality improvements unit team and system bottle neck(SBFR) task force consisting of Dr. Tekele Sheferaw, Mr. Endris Yesuf, Sister Yeshiwork Bekele, and Mr. Gebrie Tesfahun with General Manager Mrs. Sofia awod and medical director Dr Merkeni awod as well as the paediatrics and medical ward staff, is greatly appreciated.

Disclosure

The author reports no competing interests in this work.