{"id":2137,"date":"2024-11-12T10:17:37","date_gmt":"2024-11-12T10:17:37","guid":{"rendered":"https:\/\/live-champs-new.pantheonsite.io\/?post_type=resource&#038;p=2137"},"modified":"2025-08-12T13:28:10","modified_gmt":"2025-08-12T13:28:10","slug":"a-severely-malnourished-child-who-died-from-overwhelming-bacterial-infection-complicated-by-malaria-and-anemia","status":"publish","type":"resource","link":"https:\/\/champshealth.org\/resource\/a-severely-malnourished-child-who-died-from-overwhelming-bacterial-infection-complicated-by-malaria-and-anemia\/","title":{"rendered":"A severely malnourished child who died from overwhelming bacterial infection complicated by malaria and anemia"},"content":{"rendered":"\n<div class=\"wp-block-cover alignfull is-light page-header-standard\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-70 has-background-dim\" style=\"background-color:#9d6d9e\"><\/span><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"949\" class=\"wp-block-cover__image-background wp-image-2138\" alt=\"\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1.jpg\" data-object-fit=\"cover\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1.jpg 1536w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-300x185.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-1024x633.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-768x475.jpg 768w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<p class=\"has-text-align-center\">CHAMPS RESOURCES<\/p>\n\n\n\n<h2 class=\"wp-block-heading text-center\">CHAMPS Resources<\/h2>\n<\/div><\/div>\n\n\n<div class=\"publication-meta\"> \n\n<p class=\"publication-date\"> April 25, 2022 <\/p>\n\n<div class=\"publication-share\">\n\n<span class=\"share\">Share: <\/span> <ul> \n\n<li class=\"publication-share-facebook\"> <a href=\"\"> <i class=\"fa fa-facebook\"> <\/i> <\/a><\/li>\n<li class=\"publication-share-facebook\"> <a href=\"\"> <i class=\"fa-brands fa-x-twitter\"><\/i> <\/a><\/li>\n<li class=\"publication-share-instagran\"> <a href=\"\"> <i class=\"fa-brands fa-instagram\"><\/i> <\/a><\/li>\n\n<\/ul>\n <\/div>\n <\/div>\n\n <p class=\"publication-title\">A severely malnourished child who died from overwhelming bacterial infection complicated by malaria and anemia <\/p>\n\n\n<div class=\"wp-block-group content-white\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-group case-example-intro\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"has-text-align-left w-65 margin-auto\">A&nbsp;<strong>one-year, eight-month-old female<\/strong>&nbsp;was referred to a regional hospital after two weeks of fever, cough, restlessness, loss of appetite, mouth ulcers, diarrhea, and skin rash. Four days prior, her parents had taken her to a small community health facility where she was treated with antibiotics and pain medication. The mother reported that&nbsp;<strong>the child was not brought immediately to the regional hospital because they did not have money for admission<\/strong>&nbsp;and she had hoped to see improvement from treatment received at the community facility. The mother also said she purchased tablets at a pharmacy before visiting the facility to treat the child but could not recall the name of the medication. Unfortunately, neither the community health facility treatment nor the tablets improved the child\u2019s symptoms.<\/p>\n\n\n\n<p>Within the first few hours of hospital admission,&nbsp;<strong>the child tested positive for malaria<\/strong>&nbsp;via a Rapid Diagnostic Test. Hemoglobin testing indicated that she was&nbsp;<strong>anemic<\/strong>. She was subsequently treated for both conditions but ultimately succumbed to multiple contributing factors just 12 hours after hospital admission.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-group case-uncovering-causes\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-heading\">Uncovering the Causes<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>CHAMPS laboratory tests revealed presence of a lung infection caused by&nbsp;<em><strong>Klebsiella pneumoniae<\/strong>.&nbsp;<\/em>This bacterium was also found in samples of the child\u2019s blood and cerebrospinal fluid. Liver specimens showed an accumulation of extra fat cells, which is often indicative of malnutrition. Severely malnourished children are at greater risk of infection which, when affecting organs like the lungs, can lead to death. This child\u2019s underlying&nbsp;<strong>malaria<\/strong>&nbsp;and&nbsp;<strong>anemia<\/strong>&nbsp;also further weakened her immune system and the ability to fight off bacterial infection.<\/p>\n\n\n\n<p>The CHAMPS team confirmed&nbsp;<strong>severe malnutrition<\/strong>&nbsp;as the main underlying cause of death as supported by anthropometric measurements.&nbsp;<strong>Malaria<\/strong>&nbsp;and&nbsp;<strong><em>K. pneumoniae&nbsp;<\/em><\/strong>were found to be contributing causes of death in this case.<\/p>\n<\/div><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Pathology images<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"has-text-align-left w-65 margin-auto\"><strong>Lung:<\/strong><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"633\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-1024x633.jpg\" alt=\"\" class=\"wp-image-2138\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-1024x633.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-300x185.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1-768x475.jpg 768w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-1536x949-1.jpg 1536w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong>Lung showing acute aspiration (arrows) with interstitial pneumonitis<\/strong><\/figcaption><\/figure><\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"633\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-macrophage-1-1536x949-1-1024x633.jpg\" alt=\"\" class=\"wp-image-2139\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-macrophage-1-1536x949-1-1024x633.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-macrophage-1-1536x949-1-300x185.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-macrophage-1-1536x949-1-768x475.jpg 768w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-HE-arrow-2-macrophage-1-1536x949-1.jpg 1536w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong>Lung showing intraalveolar microphages (arrow)<\/strong><\/figcaption><\/figure><\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"587\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-L-T-GRAM-arrow-2-1536x881-1-1024x587.jpg\" alt=\"\" class=\"wp-image-2141\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-L-T-GRAM-arrow-2-1536x881-1-1024x587.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-L-T-GRAM-arrow-2-1536x881-1-300x172.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-L-T-GRAM-arrow-2-1536x881-1-768x441.jpg 768w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-L-T-GRAM-arrow-2-1536x881-1.jpg 1536w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong>Acute aspiration with gram-negative bacterial rods<\/strong><\/figcaption><\/figure><\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"597\" src=\"https:\/\/live-champs-new.pantheonsite.io\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-K.-pneumoniae-IHC-1-1024x597.jpg\" alt=\"\" class=\"wp-image-2140\" srcset=\"https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-K.-pneumoniae-IHC-1-1024x597.jpg 1024w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-K.-pneumoniae-IHC-1-300x175.jpg 300w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-K.-pneumoniae-IHC-1-768x448.jpg 768w, https:\/\/champshealth.org\/wp-content\/uploads\/2024\/11\/2021-0871-SLAA00579-LUNG-K.-pneumoniae-IHC-1.jpg 1099w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong>Immunostaining by using a select gram-negative bacterial immunohistochemistry (IHC) assay that detects&nbsp;K. pneumoniae<\/strong><\/figcaption><\/figure><\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-group content-white\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"has-text-align-left w-65 margin-auto\">Family Follow-up<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>The CHAMPS team&nbsp;shared resources&nbsp;with the&nbsp;family&nbsp;at&nbsp;follow-up, including education around malaria prevention,&nbsp;healthcare-seeking practices&nbsp;and the risks of self-treating from local pharmacies. They also informed the family about free and low-cost child health support available at the community-level.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<div class=\"wp-block-group case-public-health\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-heading\">Public Health Implications<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Malnutrition Screening<\/strong>: CHAMPS findings underscore the need for early identification and management of nutrition. There was likely a gap in this screening program, as the child was fully vaccinated but was not identified as malnourished at 6.5kg and 1 year 8 months old; the child should have been referred for treatment based on low weight measurements, and monitoring should be able to pick up any children who are missed. There are also free programs for nutrition to which this child could have been referred.<br>&nbsp;<\/li>\n\n\n\n<li><strong>Traditional Feeding Practices<\/strong>: Aspiration pneumonia is common in this low-income context because, when children are sick, their parents will often force-feed small children a mix of traditional herbs and a local cereal type food called&nbsp;<em>Pap<\/em>.&nbsp;CHAMPS provides education to healthcare workers and community members about the risks of force-feeding and sharing alternative ways to improve&nbsp;<em>Pap<\/em><strong><em>,&nbsp;<\/em><\/strong>such as fortifying cereals with locally available nutrients. This kind of fortification is essential to help undernourished children to build strength.<br>&nbsp;<\/li>\n\n\n\n<li><strong>Malaria Prevention<\/strong>: Education about malaria is critical. This mother lived in a city and her child was fully vaccinated and visited health care facilities often. Nevertheless gaps in general knowledge about malaria and prevention often delay parents from seeking appropriate health care for their children. This could be mitigated by training nurses and patient navigators to provide helpful information about malaria while families are waiting in health care facilities, before and after seeking care. This is a low-cost intervention for an already captive audience.<\/li>\n\n\n\n<li><strong><em>Klebsiella pneumoniae<\/em><\/strong>:&nbsp;The presence of&nbsp;<strong><em>Klebsiella pneumoniae<\/em><\/strong>&nbsp;in several CHAMPS specimens raised alarm about a possible outbreak in this area. This informed a decontamination exercise in the Special Care Baby Unit (SCBU) and involvement of infection prevention control teams, both at country-level and locally. CHAMPS supported the Ministry of Health efforts in a general supervised cleaning of the SCBU unit including disinfecting beds and equipment. Staff were also trained in proper handwashing techniques and glove usage. This message was relayed to all the other SCBUs at quarterly meetings to improve and sustain rigorous cleaning regimens. Random environmental samples were taken at these units that proved the effectiveness of the new infection prevention and control cleaning measures.&nbsp;&nbsp;<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"has-text-align-center\"><strong>Interested in more CHAMPS updates?<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><a href=\"https:\/\/ianphi.us1.list-manage.com\/subscribe?u=11ad46d81331e83cdf62a0d0a&amp;id=7fc15b483f\" target=\"_blank\" rel=\"noreferrer noopener\">Sign up for our mailing list!<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center w-65 margin-auto\">Email&nbsp;<a href=\"mailto:data@champshealth.org\">data@champshealth.org<\/a>&nbsp;for information about CHAMPS pathology slide images.<\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>A&nbsp;one-year, eight-month-old female&nbsp;was referred to a regional hospital after two weeks of fever, cough, restlessness, loss of appetite, mouth ulcers, diarrhea, and skin rash. Four days prior, her parents had taken her to a small community health facility where she was treated with antibiotics and pain medication. The mother reported that&nbsp;the child was not brought [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/champshealth.org\/resource\/a-severely-malnourished-child-who-died-from-overwhelming-bacterial-infection-complicated-by-malaria-and-anemia\/\">Read More&#8230;<span class=\"screen-reader-text\"> from A severely malnourished child who died from overwhelming bacterial infection complicated by malaria and anemia<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":2138,"parent":0,"template":"","meta":{"_acf_changed":false,"footnotes":""},"tags":[],"resource_category":[9],"class_list":["post-2137","resource","type-resource","status-publish","has-post-thumbnail","hentry","resource_category-case-example"],"acf":[],"_links":{"self":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource\/2137","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/users\/3"}],"version-history":[{"count":6,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource\/2137\/revisions"}],"predecessor-version":[{"id":4241,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource\/2137\/revisions\/4241"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/media\/2138"}],"wp:attachment":[{"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/media?parent=2137"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/tags?post=2137"},{"taxonomy":"resource_category","embeddable":true,"href":"https:\/\/champshealth.org\/wp-json\/wp\/v2\/resource_category?post=2137"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}