Judith G., 2

Gloria is the youngest child in a family of five. She lives with her parents and siblings in a small one-roomed mud-walled house. Her mother is a stay-at-home caregiver, while her father works as a casual labourer and is the sole provider for the family. When in good health, Gloria is cheerful, playful, and full of energy. Her mother reports that Gloria had been well until she suddenly developed fever (“hotness of the body”), which was followed by repeated episodes of vomiting - at times expelling worms through her mouth and nose. Alarmed, her mother sought help from the local Community Health Promoter, who administered antimalarial and deworming medication. However, despite returning home with treatment, Gloria’s condition did not improve. The fever persisted and the vomiting continued throughout the day. Determined to seek further help, her mother walked approximately five kilometres to the nearest health centre. Laboratory tests revealed heavy worm infestation and severe malaria. She was advised to proceed immediately to Siaya County Referral Hospital for advanced management. At that time, Gloria’s mother explained that she had no money for transport or treatment and was forced to return home. Later that night, at around 2:00 a.m., Gloria’s condition deteriorated further. She developed profuse diarrhea along with repeated vomiting, became extremely weak, and appeared increasingly ill. Deeply concerned, her mother carried her and walked more than 10 kilometres to Siaya County Referral Hospital in the early hours of the morning. Upon admission, Gloria was critically ill. She appeared lethargic and minimally responsive, with sunken eyes, dry lips, and signs of significant dehydration. She was febrile, weak, and pale, with rapid breathing and a fast pulse. Her body was limp, and she had difficulty maintaining alertness. She required immediate medical attention and prompt admission for stabilization. When asked why she had not come earlier after being referred, her mother tearfully explained that she feared seeking care because she had no means to pay for hospital bills. Even at that moment, she expressed uncertainty about how she would manage the costs of treatment or what would happen after discharge. It was during this time that hospital staff informed her about Helpster Charity, which supports vulnerable families who cannot afford essential medical care. This brought her some relief and hope during an otherwise overwhelming and distressing situation.

Judith was brought to the hospital with complaints of hotness of the body, and vomiting with worms,she was diagnosed with severe malaria and helminthiasis, this prompted admission to the ward. She was administered with IV Artesunate, Al, xpen , ORS after every loose stool, albendazole, mebandazole, clotrimazole among other drugs. She responded well to medication and eventually was discharged on orals. A call to the father revealed that she was well and was able to play as before

Gloria presented in a critically ill state with severe malaria complicated by severe dehydration. Severe malaria is a life-threatening condition that can rapidly affect multiple organs, particularly in young children. The combination of persistent fever, repeated vomiting, and diarrhea significantly worsened her fluid loss, leading to marked dehydration and circulatory compromise. With prompt and appropriate treatment, Gloria’s prognosis is fair. The initial 24–48 hours of management are critical in cases of severe malaria and dehydration. If she responds well to intravenous fluids, antimalarial therapy, and supportive care, gradual improvement in alertness, appetite, and strength is expected. Most children recover fully when severe malaria is treated early and adequately