Epidemiological, Clinical, and Paraclinical Profile of Malaria Patients Hospitalized for a Skin Condition in the Dermatology Department of the Libreville University Hospital Center

Abstract

Introduction: Malaria is a common parasitic infection in tropical countries, affecting both the general population and hospitalized patients. In Gabon, malaria is the leading cause of emergency room visits and hospitalizations. It is in this context that we conducted our study in the dermatology department of the Libreville University Hospital Center (CHUL). This study does not aim to describe the dermatological manifestations of malaria but rather to estimate the prevalence of malaria among patients hospitalized for dermatosis in the dermatology department. Materials and Methods: This was a retrospective descriptive study based on the medical records of patients admitted for a skin condition to the dermatology department at CHUL between January 1, 2016, and December 31, 2025 (over a 10-year period), whose thick blood smears tested positive for malaria. We also included patients who were hospitalized solely for malaria. We used Epi Info software, version 7.2, for data entry and analysis. Results: Out of 841 patient records collected, 27 patients had a positive thick blood smear. This represents a prevalence of 3.21%. The mean age was 45.44 years ± 17.87 years, ranging from 11 to 78 years. The majority of patients were female (n=15; 55.56%) and men were in the minority (n=12; 44.44%), with a male-to-female ratio of 0.8. More patients lived in a malaria-risk area (n=13; 48.14%), and few used long-lasting insecticidal nets (n=2; 7.40%). The most frequent clinical sign was fever (n=17; 62.96%). The mean trophozoite count was 16,075.85 ± 33,164.65 trophozoites/field. The mean hemoglobin level was 15.73 ± 23.69 g/dL. The mean thrombocytopenia was 224,384.62 ± 141,040.44 Giga/l. HIV-malaria coinfection was found in two cases (n=7.40%). The most frequently observed dermatoses were non-necrotizing bacterial dermohypodermitis (n=10; 52.63%) and necrotizing bacterial dermohypodermitis (n=3; 15.79%). Of the 27 patients with positive thick blood smears, 8 cases without associated dermatoses were hospitalized exclusively in the malaria ward, to alleviate pressure on the emergency department. Discussion: The prevalence of malaria varies depending on the country. A significant rate remains high in infectious disease wards. Cases of malaria persist regardless of the medical ward, hence the need for a multidisciplinary, rather than sector-specific, approach, to eradicate malaria, which is a major public health problem. Conclusion: Malaria is an infection that affects any patient, regardless of the hospital ward. Thick blood smears remain an essential test in determining the etiology of fever.