Inpatient mortality and predictors among adults hospitalized with severe malaria: a prospective cohort study in Southwest Ethiopia
- 1Department of Internal Medicine, Jimma University, Jimma, Ethiopia
- 2Department of Internal Medicine, Haramaya University, Harar, Ethiopia
- 3School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
Abstract
Background: Severe malaria remains a major public health challenge in tropical and subtropical regions, frequently resulting in multi-organ dysfunction and high mortality. Despite intensified control strategies and widespread use of antimalarial therapy, mortality rates remain unacceptably high. Moreover, data regarding inpatient mortality and its predictors at Jimma Medical Center (JMC) in Southwest Ethiopia remains limited.
Objective: This study aimed to determine the inpatient mortality and predictors among adults hospitalized with severe malaria at JMC from March 1, 2024, to February 28, 2025.
Methods: A prospective cohort study design was conducted among 250 adult patients hospitalized with severe malaria, using a consecutive sampling technique. Data were collected using Kobo Toolbox and analyzed with IBM SPSS Statistics for Windows, version 27.0. Categorical variables were summarized using frequencies, percentages, and graphs, while continuous variables were summarized using means or medians with standard deviations. Logistic regression analysis was performed to identify factors associated with inpatient mortality among patients with known final outcomes (n = 225). Statistical significance was set at p < 0.05. Crude and adjusted odds ratios with 95% confidence intervals were used to assess the strength of associations.
Results: Of the 250 adult patients hospitalized with severe malaria, 37 died during hospitalization, yielding a crude inpatient mortality rate of 14.8% (95% CI: 10.0–19.0%). In the multivariable logistic regression analysis, presence of comorbidity (AOR = 21.6, 95% CI: 4.646–50.799, P < 0.001), cerebral malaria (AOR = 12.4, 95% CI: 3.069–30.814, P < 0.001), acute kidney injury (AOR = 9.8, 95% CI: 2.828–23.867, P < 0.001), illness duration > 5 days (AOR = 6.1, 95% CI: 1.644–22.489, P = 0.007), and leukocytosis (AOR = 3.9, 95% CI: 1.135–13.866, P = 0.031) were independently associated with increased odds of inpatient mortality. Conversely, female sex (AOR = 0.20, 95% CI: 0.047–0.621; P = 0.007) and formal education (AOR = 0.20, 95% CI: 0.059–0.685; P = 0.010) were independently associated with an 80% lower odds of inpatient mortality.
Conclusion: The inpatient mortality rate among adults hospitalized with severe malaria was relatively high. Presence of comorbidity, cerebral malaria, delayed presentation beyond 5 days, acute kidney injury, and leukocytosis were independently associated with increased odds of inpatient mortality. In contrast, female sex and formal education were associated with lower odds of inpatient mortality. These findings underscore the need for timely case detection, improved access to healthcare, and early clinical intervention to reduce mortality from severe malaria.
Clinical trial number: Not applicable.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12879-026-14184-8.
Related
- Inpatient Mortality and Risk Factors Among Hospitalized Medicare Beneficiaries Ages 65 and Older with COVID-19 Treated with COVID-19 Convalescent Plasma (CCP), During 2020-2021
- Hyperlactataemia and Hypocalcaemia as Predictors of Mortality in Adult Polytrauma Patients: A Prospective Observational Study
- Incidence and predictors of early neonatal mortality among neonates admitted to neonatal intensive care units in public general hospitals in Northwest Ethiopia: a multicenter prospective cohort study.
- Clinical and Radiomics Predictors of Post-stroke Longitudinal Mortality: A Prospective Cohort Study from a Tertiary Care Hospital in India
- Associations Between Selected Autoimmune and Immune-Mediated Conditions and Lymphoma Among Hospitalized Adults: A National Inpatient Sample Analysis
BibTeX
@article{tesfaye2026inpatient,
title = {{Inpatient mortality and predictors among adults hospitalized with severe malaria: a prospective cohort study in Southwest Ethiopia}},
author = {Kenna Tesfaye and Adugna Lamessa and Monas Kitessa and Berhanu Gudeta and Daniel Yilma},
journal = {BMC Infectious Diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14184-8},
url = {https://doi.org/10.1186/s12879-026-14184-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Inpatient mortality and predictors among adults hospitalized with severe malaria: a prospective cohort study in Southwest Ethiopia
AU - Kenna Tesfaye
AU - Adugna Lamessa
AU - Monas Kitessa
AU - Berhanu Gudeta
AU - Daniel Yilma
PY - 2026
DA - 2026/08/07
JO - BMC Infectious Diseases
DO - 10.1186/s12879-026-14184-8
UR - https://doi.org/10.1186/s12879-026-14184-8
AB - Background: Severe malaria remains a major public health challenge in tropical and subtropical regions, frequently resulting in multi-organ dysfunction and high mortality. Despite intensified control strategies and widespread use of antimalarial therapy, mortality rates remain unacceptably high. Moreover, data regarding inpatient mortality and its predictors at Jimma Medical Center (JMC) in Southwest Ethiopia remains limited. Objective: This study aimed to determine the inpatient mortality and predictors among adults hospitalized with severe malaria at JMC from March 1, 2024, to February 28, 2025. Methods: A prospective cohort study design was conducted among 250 adult patients hospitalized with severe malaria, using a consecutive sampling technique. Data were collected using Kobo Toolbox and analyzed with IBM SPSS Statistics for Windows, version 27.0. Categorical variables were summarized using frequencies, percentages, and graphs, while continuous variables were summarized using means or medians with standard deviations. Logistic regression analysis was performed to identify factors associated with inpatient mortality among patients with known final outcomes (n = 225). Statistical significance was set at p < 0.05. Crude and adjusted odds ratios with 95% confidence intervals were used to assess the strength of associations. Results: Of the 250 adult patients hospitalized with severe malaria, 37 died during hospitalization, yielding a crude inpatient mortality rate of 14.8% (95% CI: 10.0–19.0%). In the multivariable logistic regression analysis, presence of comorbidity (AOR = 21.6, 95% CI: 4.646–50.799, P < 0.001), cerebral malaria (AOR = 12.4, 95% CI: 3.069–30.814, P < 0.001), acute kidney injury (AOR = 9.8, 95% CI: 2.828–23.867, P < 0.001), illness duration > 5 days (AOR = 6.1, 95% CI: 1.644–22.489, P = 0.007), and leukocytosis (AOR = 3.9, 95% CI: 1.135–13.866, P = 0.031) were independently associated with increased odds of inpatient mortality. Conversely, female sex (AOR = 0.20, 95% CI: 0.047–0.621; P = 0.007) and formal education (AOR = 0.20, 95% CI: 0.059–0.685; P = 0.010) were independently associated with an 80% lower odds of inpatient mortality. Conclusion: The inpatient mortality rate among adults hospitalized with severe malaria was relatively high. Presence of comorbidity, cerebral malaria, delayed presentation beyond 5 days, acute kidney injury, and leukocytosis were independently associated with increased odds of inpatient mortality. In contrast, female sex and formal education were associated with lower odds of inpatient mortality. These findings underscore the need for timely case detection, improved access to healthcare, and early clinical intervention to reduce mortality from severe malaria. Clinical trial number: Not applicable. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12879-026-14184-8.
SN - 1471-2334
ER -