Sherlyn S., 1

Sally is the youngest in a family of three—herself, her older sister, and their mother. Her older sister’s father abandoned their mother years ago, while Sally's father is still in school. They all share a two-room home with their elderly and ailing grandmother. Sally’s mother was raised by this same grandmother, after being abandoned by her own mother at a young age and has never heard from her since. Sally is a cheerful and lively child when around familiar people, but tends to be quiet and reserved around strangers. One Sunday night, Sally began having repeated episodes of vomiting and diarrhea, accompanied by a high fever. The next day, her mother gave her over-the-counter medication, including paracetamol, but there was no improvement. On Tuesday, she took Sally to a nearby health center, where she was diagnosed with malaria and prescribed antimalarials and pain relievers to use at home. However, later that same night around 2:00 a.m., Sally’s condition worsened. Her mother returned to the health facility the next morning and explained what had happened. The health workers advised her to seek care at a higher-level facility. With no money for transport, the clinic staff generously offered financial help, enabling her to travel to Siaya County Referral Hospital. Sally was received at the emergency department, where she was promptly treated and stabilized before being admitted for further care.

The child was brought to the hospital with complaints of fever and diarrhea. Her lab results revealed she was suffering from severe malaria and dehydration. This warranted admission, where she was admitted for a week as she received treatment. She received IV Artesunate and fluids for her dehydration and malaria; she responded well to treatment and was discharged on orals to take at home. A visit by the volunteer to their home revealed Sherlyn was well, and he found her playing in their compound. The mother expressed her gratitude, as she had been scared that if the child was admitted, she would be detained at the hospital because the bill was going to be too much for her to afford, and she had contemplated going back home with the child. But the dire situation in which the child was made her change her mind.

This is a life-threatening condition requiring urgent hospital admission and immediate intervention, but the prognosis is good. The clinical presentation suggests significant red blood cell destruction from the malaria infection, contributing to the anemia. The combination of these two conditions increases the risk of circulatory collapse, hypoxic injury, and multi-organ dysfunction, particularly in young or malnourished children.