Children with Sickle Cell Disease in Northern Benin: Follow up of a Cohort at the Borgou/Alibori Branch of Integrated Medical Healthcare Center for Infants and Pregnant Women with Sickle Cell Disease from 2017 to 2022

Introduction: Sickle cell disease is a public health problem in sub-Saharan Africa. A national referral center for the management of infants and pregnant women with sickle cell disease (CPMI-NFED) was created three decades ago in Cotonou, in the south of Benin with two regional branches including that of Parakou in the North for better access of patients to specialized care. This work is a review of five years of activities in order to describe the epidemiological, clinical, hematological and evolutionary profiles of the children followed up in the said branch. Method: This was a descriptive and retrospective cross-sectional study on the medical records of children with sickle cell disease, followed up at the regional branch of CPMI-NFED in Borgou/Alibori from June 1, 2017 to May 31, 2022. The variables studied were epidemiological, clinical, biological and evolutionary. Results: A total of 101 children with sickle cell disease were included in the study, including 78 homozygous SS (77.2%) and 23 heterozygous SC (22.8%). Their mean age at inclusion was 51.2 ± 37.6 months [6 - 204]. The sex ratio was 1.4. Vaso-occlusive crises were the main diagnostic circumstances in 42.3% of homozygotes. More than half of the children (51.5%) had a regular follow-up. The average baseline level of hemoglobin (Hb) in homozygous children was 8.8 ± 1.4 g/dl [5.8 - 11.5];and the rate of Hb S varied between 61.9 and 94.7%. In heterozygous SC children, the mean baseline level of Hb was 10.7 ± 0.6 g/dl [9.7 - 11.5]. Acute complications observed during follow-up were dominated by pneumonia and vaso-occlusive crises in both phenotypes. The overall mortality was 3% and only affected homozygous patients. Conclusion: On average, three out of four children were homozygous in our cohort. The main acute complications were infectious and vaso-occlusive. The mortality only affected homozygous carriers. Specialized follow-up has contributed to improving the quality of life of children with sickle cell disease. This could be implemented on a large scale for better survival of children with sickle cell disease.

Early Morbidity and Mortality in Neonates of Mothers with Sickle Cell Disease at the Borgou/Alibori Center Departmental Teaching Hospital in Benin

Introduction: Association of sickle cell disease and pregnancy is a risky situation for both the mother and neonate. Objective: To determine the early morbidity and mortality among neonates of mothers with sickle cell disease at Borgou/Alibori Center Departmental Teaching Hospital (CHUD B/A) in Benin. Patients and Methods: This was a descriptive and analytical observational study conducted at CHUD-B/A from January 1, 2015, to August 31, 2019. It included pregnant women with sickle cell disease who gave birth to a liveborn neonate at the term of at least 28 weeks of amenorrhea. Variables studied were sociodemographic, clinical, and evolutionary. Analysis of the factors associated with early death was also carried out with a significance threshold set at p Results: Out of a total of 119 pregnant women, 95 neonates were recorded. Main morbidities were: prematurity and intrauterine growth restriction (49.5%);respiratory distress (40%), bacterial infection (30.5%), and perinatal asphyxia (21.1%). Early mortality rate was 8.4%. In bivariate analysis, the factors associated with early death were: parity (p < 0.001), the severity of maternal anemia (p < 0.008), birth weight under 1500 g (p < 0.002), the birth term under 32 weeks of amenorrhea (p < 0.001), resuscitation for at least 5 minutes (p = 0.001). In multivariate analysis, resuscitation for at least 5 minutes (p = 0.007) was mainly associated with early death. Conclusion: One out of two neonates of mothers with sickle cell disease has a low birth weight. Early mortality is high due to perinatal asphyxia. Hence the multidisciplinary care of these mothers.

Prevalence of Undernutrition among Children Aged 6 - 59 Months in the Municipality of Toucountouna (Benin) in 2017

Introduction: Undernutrition is a public health problem in the world and especially in developing countries. According to the demographic and health survey with multiple indicators of Benin IV (DHS-MICS-IV), the prevalence of acute undernutrition (AU), chronic undernutrition (CU) and that of underweight (UW) was 16%, 45% and 21%, respectively. The objective of this work was to determine the prevalence of undernutrition in children aged 6 to 59 months in the municipality of Toucountouna in 2017. Materials and Methods: This was a descriptive cross-sectional study with two-stage cluster random sampling, composed of 390 children aged 6 to 59 months, living in the municipality of Toucountouna for at least six months. The study variables were: socio-demographic, economic, behavioral, socio-sanitary and anthropometric. Data were entered and analyzed using Epi-info 7.2 software. Results: 203 out of 390 children included, were boys (sex ratio of 1.08). The mean age of the children was 28.70 ± 11.79 months. The prevalence of AU, CU and UW was 10.26%, 31.54% and 11.79%, respectively. Conclusion: The results of this study showed that efforts remain to be made in terms of undernutrition and other surveys could identify the determinants linked to this situation in the locality for the effective implementation of prevention.

Factors Associated with Low Use of Insecticide-Treated Nets among Children under 5 Years of Age in Fo-Boure (Benin) in 2019

Despite the free distribution of insecticide impregnated nets, malaria is still the cause of many deaths, particularly among children under 5 years old, casting doubt on the real use of these mosquito nets by parents. The present work aimed to identify the factors associated with the low use of mosquito nets. This was a cross-sectional study with an analytical aim, carried out in the locality of Fô-Bouré (Sinendé) in 2019 among children under 5 years old and their parents. A cluster random sampling was carried out according to the WHO technique. The dependent variable was the low use of LLINs and the independent variables were: socio-demographic, economic, relative to parents’ knowledge of the causes and control methods of malaria. Results: The factors identified as associated with the low use of LLINs were: female sex (p = 0.0059), low level of education (p = 0.0001), free mode of acquisition (p = 0.0476), poor knowledge of control methods (p = 0.0389), type of house: mud or tent house (p = 0.0034), unsanitary immediate environment (p = 0.0002) and children’s evening dressing style (p = 0.0001). Conclusion: A global development policy, especially in terms of education, sanitation and housing improvement as recommended by the “Roll Back Malaria” initiative is necessary to improve the rate of insecticide impregnated nets use. .

Serotypes of Bacteria Encountered in Childhood Purulent Meningitis in Children in Parakou (Benin) in 2011

Introduction: In the North-Benin, there are three agents causing pediatric purulent meningitis outside the neonatal period. These are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. The aim of this research work was to investigate bacteria serotypes that caused childhood purulent meningitis in the pediatric unit of the Borgou à Regional University Teaching Hospital (CHUD-Borgou) located in Parakou (North-Benin). Patients and Methods: Through a prospective and descriptive study centered on children aged 0 to 5 years old suspected of meningitis and hospitalized, the cerebrospinal fluid (CSF) samples of those children were analyzed at the WHO reference laboratory in Banjul for serotyping by real time polymerase chain reaction (RT/PCR). Results: Among the 1396 children hospitalized during that period, 366 were suspected of meningitis and had benefitted from lumbar puncture. Among those 366 suspected cases, 51 cases of purulent meningitis were confirmed after CSF cytobacteriological and biochemical test at the CHUD-Borgou laboratory. Among 51 CSF samples in which purulent meningitis was confirmed, 44 were sent to Banjul. In addition, 310 CSF samples from non-confirmed cases of meningitis were also sent to Banjul. In the whole set of samples sent for real time PCR, 151 cases of Streptococcus pneumoniae (42.7%) were found, 5 cases of Neisseria meningitidis (1.4%) and 1 case of Haemophilus influenzae (0.3%) were also encountered. As regards Streptococcus pneumonia, the serotypes encountered were: 1, 3, 4, 5, 7F, 8, 9V, 9V/9A, 9N/9L, 14, 18C, 19A, 23F, 33F as well as non typed and non typable serotypes. As for Neisseria meningitidis, only serogroup A was found in it. For Haemophilus influenzae, only serotype b was identified. Conclusion: Four non vaccine serotypes (8, 9V/9A, 9N/9L and 33F), non typed and non typable serotypes which are not covered by 13-valent pneumococcal conjugate vaccine (PCV 13) were identified. This highlights the need to enhance surveillance of pediatric purulent meningitis and serotyping by RT/PCR of all CSF samples in order to adapt if necessary future new pneumococcal vaccines to circulating non vaccine serotypes.

Neonatal Morbidity and Mortality from 2010 to 2016 in the Neonatal Care Unit of the University Teaching Hospital of Parakou/Benin

Introduction: Neonatal mortality accounts for 44% of deaths among children. This study aimed to investigate neonatal morbidity and mortality in the neonatal care unit of the University Teaching Hospital of Parakou (CHU-P) from 2010 to 2016. Patients and Methods: This research was a retrospective, descriptive and analytical study that covered the period from January 1, 2010 to December 31, 2016. It focused on the medical records of newborns hospitalized in the said unit during the period mentioned above. Study variables were sociodemographic, clinical, paraclinical and outcome. Findings: During the time span of the study, 6204 newborns were registered. Sex ratio was 1.32. Mean age for newborns was 6.01 ± 5.39 days. Clinically obvious neonatal infection (54.1%), prematurity and low birth weight (34.8%) and perinatal asphyxia (30%) were the main diseases of newborns recorded in the unit during the study period. Mortality rate was 16.8% including 77.9% occurred in the first week of life and 62.1% in the first 24 hours of life. Conclusion: More than one in six newborns died and three out of five deaths occurred in the first 24 hours of life. Therefore, it seems wise to carry out a case-control study with multivariate analysis in order to identify the main risk factors for that mortality.

Newborn Umbilical Cord Care in Parakou in 2013: Practices and Risks

Objective: The objective was to study umbilical care practices and risks in Parakou (North Benin). Patients and method: It was a cross-sectional and descriptive study carried out within a community from June 1 to August 31, 2013. It focused on all the infants born at the maternity of Parakou Health Center and their mothers. Results: Two hundred and ten newborns were included i.e. 101 boys and 109 girls. In 80.9% of cases, inappropriate substances had been applied to umbilical cord. Umbilical cord care quality was adjudged as poor, acceptable and good in 58.6%, 31.9% and 9.5% of cases respectively. A bacterial umbilical infection had been noted in 59.5% of newborns. Only 4.8% had sterile umbilical wound. The commonest bacteria were: Staphylococcus aureus (58.1%), Staphylococcus saprophiticus (53.3%), Escherichia coli (44.8%) and Pseudomonas aeruginosa (14.3%). The factors associated with umbilical infection were: low educational status of mother (p = 0.026), low-income occupation of mother (p = 0.021), customary practices to accelerate umbilical cord fall off (p = 0.007), short time to cord falling off lower than 6 days (p = 0.015). Conclusion: Umbilical cord care involves high risk for bacterial infection in our context. Strong actions must be taken within the community in order to reduce that risk.

Neonatal Bacterial Infections in Parakou in 2013

Objective: Neonatal bacterial infections are a leading cause of mortality in developing countries, including Benin. This study aimed to investigate the epidemiological, clinical and bacteriological aspects of neonatal bacterial infections and their outcomes in the neonatal care unit of the Borgou Regional University Teaching Hospital (CHUD-Borgou). Study design: This manuscript described a cross-sectional study with prospective data collection and an analytical purpose that was performed over the course of 3 months. It was conducted in the neonatal care unit of CHUD-Borgou and focused on 203 newborns who were admitted for suspected bacterial infection. Results: Neonatal bacterial infections accounted for 63.75% of admissions. The sex ratio was 1:1. Prematurity was the main reason for admission (25.1%), and respiratory distress was the most common physical symptom (22.2%). From a bacteriological point of view, 14.7% of blood cultures were positive, and the main isolated pathogens were Escherichia coli (35.8%), Staphylococcus aureus (21.5%) and Klebsiella pneumoniae (14.3%). These pathogens were more sensitive to aminoglycosides than to other antibiotics. Lethality was 21.6%. Place of birth (p < 10-3), age of the newborn at admission (p = 0.003) and maternal history of infectious diseases during pregnancy (p = 0.02) were factors associated with neonatal bacterial infections. Conclusion: This study identified the main pathogens responsible for neonatal bacterial infections and their level of sensitivity to antibiotics. It also determined the different factors associated with neonatal bacterial infections that should be considered in newborn care.

Frequency of Hypovitaminosis D in 6 - 59 Month Children with Severe Malaria in the Pediatrics Unit of the Teaching Hospital of Parakou (CHUD/BA) in Benin in 2016

Introduction: Vitamin D’s action outside of bone, especially on immunity, is widely reported in the international scientific literature over the last years. Objective: Calculate the frequency of hypovitaminosis D in children aged 6 to 59 months suffering from severe malaria in the CHUD-P pediatric unit in 2016. Setting and Methods: This research work is a cross-sectional study with descriptive and analytical purposes. Data gathering was prospective. The study involved children aged 6 to 59 months hospitalized for severe malaria in the CHUD-P pediatric unit. The said children were HIV-uninfected, eutrophic and had not received vitamin D supplementation during the last 6 months. Vitamin D dose was measured using the High Performance Liquid Chromatography (HPLC) technique. Results: A total of 80 subjects were involved in the survey. Mean age was 26.08 months, sex ratio was 0.8 and average weight was 10.80 kg. Hypovitaminosis D frequency was 83.8% (67 cases out of 80 children investigated during the survey) with an average plasma concentration of vitamin D estimated at 21.57 ng/ml ± 7.34 with two extremes (11.24 - 42.32) ng/ml. The minimum parasitaemia was 202 P/μl and the maximum was 580,000 P/μl. Conclusion: Hypovitaminosis D is common in children suffering from severe malaria;this result suggests conducting a large-scale community-based study to decide on vitamin D inclusion in national supplementation policies and severe malaria management.

Benefits of Artesunate versus Quinine in the Treatment of Children with Severe Malaria at the National University Teaching Hospital of Cotonou

Introduction: Severe malaria is one of the leading causes of death in Sub-Saharan African countries, and artesunate is recommended as a first-line treatment by the Word Heath Organization (WHO.). Objective: Identify the advantages of artesunate compared with quinine in the treatment of severe malaria in children. Methods and patients: This study was a cross-sectional, descriptive and analytical study focused on children hospitalized for severe malaria in the CNHU who were treated with quinine or artesunate. Findings: The hospital-based frequency rate of severe malaria in pediatric patients was estimated to be 28.3% (n = 848). One hundred five children were treated with artesunate, and 743 were treated with quinine. The mean age of the children was 47 months old. The primary signs of severity were anemia (n = 776), neurological manifestations (n = 309) and hemolysis (n = 137). The average duration of treatment was 1.95 days for artesunate versus 2.45 days for quinine, and the difference was statistically significant (p = 0.001). The average length of stay (ALOS) in the hospital was 5 days for the artesunate group versus 5.75 days for the quinine group, and the difference was statistically significant (p < 0.001). Six of the children who received artesunate died, whereas 24 children who treated with quinine died. The total average cost of healthcare was 50,600 FCFA (77 euros) per child treated with artesunate versus 57,100 FCFA (87 euros) per child treated with quinine. Conclusion: The treatment of severe malaria with artesunate is superior to quinine-based treatment.

Contribution of the Urine Dipstick to Urinary Tract Infection Diagnosis among Children in Two Hospitals in Cotonou-Benin

Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood pressure and renal failure. The purpose of this study was to determine the contribution of a urine dipstick (UD) to the diagnosis of urinary infections among children at the CNHU-HKM and the Lagoon Mother and Child University Teaching Hospital (CHU-MEL) of Cotonou. Patients and Methods: This study is a cohort, descriptive and analytical study focused on children with suspected urinary infections in the pediatric units of the CNHU-HKM and CHU-MEL of Cotonou from March 25 to August 25, 2015. Results: Two hundred and four children out of a total of 5125 admitted children (4%) presented with at least one clinical sign of a urinary tract infection. Children under 36 months of age were predominant (41%). The main clinical signs of urinary infections were fever (60.8%) and urinary disorders (38.2%). The urinary dipstick test was positive in 145 children (71.2%). A urinary tract infection was confirmed by urine culture in 38 children (18.6%). In cases with leucocyturia- and nitrituria-positive urine dipstick tests, the sensitivity was estimated to be 13.2%, and the specificity was 95.2%, with a negative predictive value (NPV) of 82.8%. Only when the leucocyturia test was positive, the sensitivity was 76.3%, and the specificity was 31.9%. When the leucocyturia test was negative, the specificity was estimated to be 94%, and the sensitivity was 83% in the nitrituria-positive cases and 15.8% in the nitrituria-negative cases. The main isolated pathogens were Escherichia coli (n = 21) and Klebsiella pneumoniae (n = 14). Conclusion: In our environment, a negative leucocyturia test may help exclude urinary tract infections in most cases.

Hypovitaminosis D in 6 - 59-Month Children in the District of Parakou (Benin) in 2017

Introduction: Nutritional rickets is the visible tip of the iceberg formed by the diseases caused by hypovitaminosis. Vitamin D plasma is essentially influenced by the level of sunlight which is significant in Sub-Saharan Africa and in Benin. However, there are factors likely to impede endogenous production of that vitamin in children in our environment. This research work was conducted with the view to investigate hypovitaminosis D prevalence and associated factors in children aged 6 to 59 months in the District of Parakou in 2017. Methods: This research work was a cross-sectional study with prospective collection of data carried out in community in the District of Parakou in 2017. The study involved euthrophic and non-HIV infected children aged 6 to 59 months who did not benefit from vitamin D supplementation during the past three months. Vitamin D plasma concentration was obtained using “Radioimmunoassay” after cluster random sampling in accordance with WHO guidelines. According to Schwartz formula, nominal minimum sample size was 321. In this study, hypovitaminosis D was defined as a plasma level lower than 30 ng/l. Data processing was carried out using softwares such as EPI INFO version 7.2 and SPSS 21. Results: In total, 400 children were involved in the survey. Hypovitaminosis prevalence was 9.5% (38 out of 400 cases). In our research work, the factors associated with hypovitaminosis were child’s age (p = 0.0470), mother’s age (p = 0.0000), weaning age lower than 6 months (p = 0.0466) and mother’s occupation out of direct sunlight (p = 0.0012). Conclusion: Nearly one out of ten children suffers from hypovitaminosis D in the District of Parakou in 2017. The associated factors were age of child and mother, early weaning and mother’s professional occupation held out of direct sunlight. This research work should be continued and improved by a nationwide multicentre study. This could lead to the adoption of measures for hypovitaminosis D prevention among children in Benin.

Relationship between Early Breastfeeding, Exclusive Breastfeeding and Continuation of Breastfeeding until 24 Months in Parakou in 2016

Introduction: Early breastfeeding is recommended by the WHO as one of the essential practices for child nutrition. Objective: To identify the relationship between early breastfeeding, exclusive breastfeeding (EBF) and continuation of breastfeeding up to 24 months of age. Patients and Methods: This research is a cross-sectional, descriptive and analytical study conducted in the District of Parakou (Benin) in November 2016. Sampling was probabilistic and used the WHO cluster sampling technique. Children aged 6 to 24 months and their mothers were included. The main variables investigated during the study were related to practices of early breastfeeding, EBF and continuation of breastfeeding until 24 months of age. The data collected through direct interview were entered and processed using the Epi-info 7.2 software. Chi-squared test was used to compare proportions;the differences existing between the proportions were considered as significant if p Findings: Among the 420 children included, the prevalence of EBF was 26.67%. EBF and continuation of breastfeeding up to 24 months were statistically related to early breastfeeding with p values estimated at 0.014 and 0.047, respectively. Conclusion: Improving and enhancing the performance of breastfeeding practice should be possible by promoting early breastfeeding.

Congenital Malaria in the Borgou/Alibori Regional University Teaching Hospital: Myth or Reality?

Introduction: The occurrence of malaria is classically described as uncommon or exceptional in the neonatal period. This work aims to describe the epidemiological, diagnostic, therapeutic, clinical features and outcomes of congenital malaria in the Borgou/Alibori Regional University Teaching Hospital (CHUD B/A) located in Parakou. Patients and Methods: This research is a cross-sectional and descriptive study that was conducted in the neonatal intensive care unit of the CHUD B/A from January to December 2017. It included and involved all newborns less than eight (08) days old with positive thick smears. Comorbidities were taken into account to establish the diagnosis of congenital malaria with accuracy. Findings: A total of 170 newborns out of 892 newborns admitted tested positive with Plasmodium falciparum thick smears, i.e., a hospital-based frequency of 19%. The sex ratio was 1.1. The mean age was 22.44 ± 2.72 hours. There was malaria-bacterial infection comorbidity in 39.3% of cases. Among the 91 cases of thick smears testing positive without stigma of bacterial infection, G6PD deficiency and fetal-maternal Rhesus incompatibility, the main reasons for admission were prematurity (51.6%), low birth weight (44%), neonatal distress (31.8%) and respiratory distress (15.3%). In addition, the main signs found during the physical examination were neurological disorders or impairments (43.9%), respiratory distress (30%), hyperthermia (12.1%) and jaundice (4.4%). The mean or median parasitemia was 490 parasites/μl, with extremes ranging from 100 to 6500 parasites/μl. Treatment was based on artemisinin derivatives. The patient condition improved in 88.7% of cases. Overall mortality was estimated at 11.9%, and the specific mortality was 13.2%. Conclusion: Congenital malaria is a reality that actually prevails in the CHUDB/A. It has become vital and urgent to explore innovative, effective and efficient strategies to ensure its management and prevention. A study using PCR as the gold standard should be conducted to better assess the extent and magnitude of the disease.

Epidemiological, Clinical, Biological, Therapeutic Features and Outcome of Congenital Malaria at the Borgou Regional University Teaching Hospital (CHUD-B) in Benin in 2015

Background: The prevalence of congenital malaria is getting more and more significant in Sub-Saharan Africa where is a malaria-endemic area. This study aimed to identify the clinical and therapeutic features as well as the outcome of congenital malaria in CHUD-B in 2015. Method: It was a cohort and descriptive study with analytical purpose, carried out in the Mother and Child Department which includes the Gynecology & Obstetrics and Pediatric Unit of CHUD-B. The study target population consisted of all the infants born in the CHUD-B as well as their mothers. The main variable was the presence of congenital malaria. The independent variables were those related to clinical, therapeutic features and outcome. Results: In the study, among the 300 newborns registered, 57 carried congenital malaria i.e. a prevalence of 19%. 171 (57.0%) of them were males versus 129 (43.0%) females. Among the 281 mothers involved, 48 presented with malaria in pregnancy i.e. a prevalence of 17.0%. At the end of this research work, the factors associated with congenital malaria were fever in the 3rd quarter and malaria in pregnancy in the mother. Conclusion: Nearly one out of five infants born in the CHUD-B was carrier of congenital malaria and approximately one out six mothers presented with malaria detection during pregnancy. A method based on Polymerase Chain Reaction (PCR) should be implemented during the diagnosis in order to confirm malaria cases among both newborns and mothers.

Progression of Frequency and Lethality of Severe Malaria from 2017 to 2020 in the Pediatric Unit of CHUD-Parakou (Benin)

Background: The latest WHO report shows a decline in the performances achieved concerning the fight against malaria since 2017. This research work aimed to investigate the progression of frequency and lethality due to severe malaria from 2017 to 2020 in the pediatric unit of the Borgou University Teaching Hospital in Parakou (CHUD-Parakou). Patients and Methods: This research work is a descriptive and analytical case-control study focused on all the children aged 1 month and more, hospitalized in the pediatric unit of CHUD-Parakou from January 1, 2017, to December 31, 2020. Recruitment criteria were the following: be admitted to hospital during the period specified above;have a usable medical record containing the diagnosis and type of discharge, and the findings of thick smear examination and/or of a rapid diagnostic test. Sampling was complete and takes into account all the medical records of children meeting the inclusion criteria. Epi Info 7.2.2 was the software used to perform data processing. Results: The frequencies of severe malaria in the unit were estimated at 19.89%, 22.65%, 29.65% and 27.51% respectively in 2017, 2018, 2019 and 2020. Lethality rates varied from 7.76% to 8.68 from 2017 through 2020. The death risk associated with severe malaria was 3.08 times higher in children suffering from severe acute undernutrition. Conclusion: Despite all the efforts made by the health authorities and the technical and financial partners, the frequency and lethality of severe malaria are increasing in the pediatric unit of the B/A Regional University Teaching Hospital (CHUD-B/A). It is therefore worth investigating the determinants of this situation.

The Determinants of Fatal Outcomes during Severe Malaria in Children at the HKM University Teaching Hospital of Cotonou-Benin

Introduction: Malaria particularly affects children in sub-Saharan African countries. This study aimed to investigate the factors associated with death in cases of severe childhood malaria to better understand the determinants of death in these children. Patients and Methods: This cohort, descriptive and analytical study was conducted from April 1 to August 15, 2015, at the CNHU-HKM pediatric clinic in Cotonou. Recruitment was exhaustive for all patients under 15 years of age who were admitted for severe malaria, as confirmed by thick smear microscopy. Results: Among the 1774 admitted patients, 449 had severe malaria caused by Plasmodium falciparum (i.e., a hospital frequency of 25.31%). The age group most affected consisted of children younger than 60 months of age (73%);female predominance was noted. The lethality rate of malaria was 13.1% (n = 59). The factors associated with death were coma (p = 0.032), poor convulsive status epilepticus (p = 0.08) and bacterial co-infection by gram negative bacteria (p = 0.021) with respectively correlations coefficient of 0.003, 3.940 and 2.424. Conclusion: Reduction of the malaria mortality rates in Benin hospitals will depend on appropriate management of poor prognostic factors, such as coma, bacterial co-infection and convulsive illness.