Precious A., 7

Precious is the fourth-born in a family of five children. She is disciplined, kind and determined, enjoys reading and dreams of becoming a doctor so that she can care for people in her community. The family lives in an area where the nearest reliable water source is more than an hour’s walk away. Her father is the household’s primary income earner, making approximately USD 25 per month, which must meet the basic needs of the entire family. Precious was referred from Lunakwe Dispensary following a previous admission and recurrence of illness. She presented with repeated vomiting, convulsions and refusal to feed. Her condition had progressively deteriorated, with increasing weakness and reduced activity. She was unable to tolerate food or fluids and became increasingly lethargic between episodes of convulsions, causing significant concern to her caregiver. The combination of seizures, persistent vomiting, poor feeding and altered activity indicated a seriously unwell child requiring urgent hospital assessment, inpatient management and close monitoring to establish and treat the underlying cause and prevent further complications.

Precious was diagnosed with malaria with febrile convulsions, requiring inpatient treatment and close observation. Her seizures, vomiting, refusal to feed and lethargy indicate significant illness, with risks including recurrent convulsions, dehydration, hypoglycaemia and progression to severe or cerebral malaria. She requires appropriate antimalarial therapy, fever and seizure management, hydration and neurological monitoring. With prompt treatment and no further complications, her prognosis is favourable, although continued observation until clinically stable is important.