Rihanna S., 2

Rihanna Santiviah is a two-year-old girl born to a young teenage mother who sadly passed away during childbirth due to complications. The family was unable to access hospital care at the time because of financial constraints. A year later, her father also died, leaving Rihanna an orphan. She is now being raised by her grandmother, who lives with a disability, in a rural village where life is extremely challenging. The family depends on her grandfather, who works on plantations and earns a small income that is barely enough to meet their needs. About a week prior to presentation, Rihanna became unwell at home. Due to lack of funds, the family was unable to take her to a health facility and instead sought help from a Community Health Promoter (CHP), who provided some basic treatment. However, her condition continued to worsen with no improvement. Recognizing the severity of the situation, the CHP—who is linked to the health facility and aware of the support offered by Helpster Charity, from which Rihanna had previously benefited—decided to refer her for further care. The CHP reported that Rihanna had been experiencing frequent episodes of diarrhoea and persistent fever for more than a week. By the time she was brought to the hospital, she was severely dehydrated, with visibly sunken eyes, a dry mouth and lips, reduced skin elasticity, weakness, lethargy, and minimal responsiveness. She was also unable to feed properly and appeared critically ill. She was promptly received at the facility for urgent medical attention, requiring immediate rehydration and close monitoring to stabilize her condition.

Rhiana, aged two years, was admitted on 26/02/2026 with a diagnosis of hypoglycemia with severe malaria after presenting with fever, weakness, and poor general condition. On admission, she was promptly started on 10% glucose to correct the low blood sugar and prevent further complications, with Ringer’s lactate given in alternation to maintain hydration and support circulation. She was also managed with intravenous artesunate for severe malaria, X-pen injection for treatment of associated bacterial infection, and paracetamol suppository followed by paracetamol suspension for fever and pain control. Zinc sulphate was included as supportive treatment to enhance recovery and improve general wellbeing. During her stay in the ward, Rhiana responded steadily to treatment, with improvement in energy levels, reduction of fever, stabilization of blood sugar, and return of feeding and activity. Her condition progressively improved without complications, and by 28/02/2026 she was clinically stable and fit for discharge. She was discharged on Coartem to complete antimalarial treatment and azithromycin for continued outpatient care, with a good prognosis and expected full recovery.

Rhiana is suffering from a critical pediatric illness requiring inpatient management due to the combined danger of severe dehydration, severe malaria and hypoglycemia. Severe malaria in a child of two years can progress very quickly and may result in complications such as severe weakness, persistent fever, convulsions, anaemia, dehydration, impaired consciousness, and even death if not properly managed. The presence of hypoglycemia made the case more urgent because low blood sugar in a young child can severely affect the brain and general body function within a short period. Admission was necessary to allow for immediate correction of blood glucose levels through intravenous fluids, administration of injectable antimalarial treatment, control of fever, prevention of dehydration, and continuous monitoring of the child’s response to treatment. With timely and appropriate hospital care, Rhiana’s prognosis was good, and she was expected to recover well without lasting complications. However, without admission and close observation, the condition could have worsened rapidly and placed her life at significant risk.