Precious S., 10

Precious is a 10-year-old Grade Four pupil and the second-born in a family of five children. With both parents’ whereabouts unknown and her grandfather deceased, she and her siblings depend entirely on their grandmother. They live in a two-room mud house without electricity and walk over 30 minutes to obtain water. Their grandmother earns about USD 12 monthly selling firewood, which is insufficient for food, schooling and healthcare. Precious developed a four-day history of high fever with chills, severe headache, repeated vomiting, poor appetite and progressive weakness. Despite home care, she deteriorated and became drowsy, difficult to wake and unable to eat or drink. Following advice from a Helpster volunteer, her grandmother brought her to Bulondo Hospital. On admission, Precious was critically ill, with a temperature of 39.6°C, and impaired consciousness. Investigations confirmed cerebral malaria with moderate dehydration. She was urgently admitted, intravenous access established, and IV fluids, appropriate antimalarial therapy and supportive care commenced. She remains under close monitoring, stable but seriously ill.

Precious, a 10-year-old child diagnosed with cerebral malaria and moderate dehydration, should be admitted to hospital for urgent treatment. Management begins with intravenous (IV) or intramuscular (IM) artesunate according to recommended dosing guidelines to treat the malaria infection. Moderate dehydration is corrected with carefully monitored oral rehydration solution (ORS) if the child can safely swallow, or intravenous fluids if consciousness is impaired. Blood glucose, vital signs, fluid balance, and neurological status are monitored closely, and fever is managed with antipyretics such as paracetamol. Supportive care is essential throughout treatment. The child is monitored for seizures, anaemia, hypoglycaemia, and other complications associated with cerebral malaria. If seizures occur, appropriate anticonvulsant medication is administered. Oxygen therapy, blood transfusion (if severe anaemia is present), and nutritional support may also be provided as needed. Frequent reassessment helps ensure that hydration is corrected without causing fluid overload. With prompt and appropriate treatment, Precious is expected to show gradual improvement in hydration status, regain consciousness, and recover from the malaria infection over several days. Fever subsides, neurological function improves, and laboratory findings return towards normal. However, follow-up is important because some children recovering from cerebral malaria may experience persistent neurological or cognitive complications that require ongoing assessment and rehabilitation.

Precious presented with cerebral malaria and moderate dehydration, with high fever, vomiting, marked weakness and impaired consciousness (GCS 11/15). This is a medical emergency requiring intravenous antimalarial therapy, careful fluid management and close neurological monitoring. Cerebral malaria may cause seizures, coma, neurological disability or death if treatment is delayed. Her current stability is encouraging, but the condition remains serious. With prompt treatment and improving consciousness, her prognosis is cautiously favourable, with follow-up needed for possible neurological effects.