Ruel A., 4

Ruel is a four-year-old nursery pupil and the youngest of five children living with both parents in Ayueyo near Ahero. Her father is the sole breadwinner and also supports his elderly parents, leaving the household with very limited resources. The family lives in a grass-thatched mud house without a toilet and depends on a neighbour’s latrine. Ruel was brought to a medical outreach appearing seriously ill, weak and exhausted. She had repeated vomiting, cough, high fever and an episode of convulsions. She had poor appetite, reduced activity and was unable to play or interact normally. Her weakness was significant, and she appeared lethargic and visibly unwell. Following clinical examination and investigations, she was diagnosed with severe malaria and anaemia, requiring urgent hospital admission, appropriate treatment and close monitoring.

Ruel presented with severe malaria complicated by anaemia and convulsions, indicating significant illness requiring urgent inpatient treatment. Severe malaria can rapidly cause worsening anaemia, recurrent seizures, hypoglycaemia, altered consciousness and organ dysfunction if inadequately treated. Appropriate antimalarial therapy, management of the anaemia, hydration and close monitoring are essential. With timely treatment and a good clinical response, Ruel’s prognosis is favourable.