Severe malaria-related disability in African children
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University of Gondar, Gondar city, Ethiopia
Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
School of Rehabilitation Therapy, Queen's University, Canada
Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Ethiopia
School of Rehabilitation Therapy, Queen's University, Kingston, Canada
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1052
Background and Objective: The prevalence of severe malaria among children in African hospital-based studies is nearly 39%, and roughly 53% of children who survive severe malaria develop long-term sequelae. However, these consequences have not been studied from a disability and rehabilitation perspective. Therefore, this study aimed to assess severe malaria-related disability in Ethiopian children from the biopsychosocial perspective. Methods: Three independent but interrelated studies were conducted: (1) a systematic review of the African severe malaria literature in children that summarized the components of disability using the International Classification of Functioning, Disability, and Health (ICF), (2) an interpretive descriptive study of severe malaria-related disability from the perspectives of caregivers, and (3) a qualitative descriptive study that explored the perceptions and behaviors of healthcare providers towards severe malaria-related disability, using the Theoretical Domains Framework. The purposive sampling technique was used in both qualitative studies, and reflexive thematic analysis and directed content analysis were used to analyze data in the second and third studies. Results: This study identified three integrated findings: (1) physical, psychological, and social functioning are notable components of disability related to severe malaria; (2) various contextual factors interacted with severe malaria and act as either barriers or facilitators of functioning, and (3) healthcare providers were focused on acute care, and they perceived that there were no rehabilitation support systems for severe malaria-related disability. Conclusions: Severe malaria-related disability is associated with impairments, activity limitations, and participation restrictions in African children. However, these children were not included in rehabilitation support and care. Implications: Future research should consider the components of disability identified in this study on a large scale. In addition, policymakers should consider funding post-severe malaria follow-up care and rehabilitation support systems, and rehabilitation professionals should include children with severe malaria-related disabilities in their care and support system. 
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