Posted 30/07/2019. Malaria has been falling in Africa over the last few decades. This reduces the number of children with infection, but the lowered exposure to malaria could change the clinical picture. Work in KEMRI-Wellcome Programme shows this leads to more cerebral malaria and in older children, but fortunately no increase in death rates.

Posted 26/07/2019. Although WHO rehydration management guidelines (Plan C) for severe dehydration are widely practiced in resource-poor settings, they have never formally been tested in a clinical trial, despite poor outcomes (mortality). Kathryn Maitland and colleagues evaluated current recommendations versus a slower rehydration regime in Ugandan/Kenyan with severe dehydration secondary to gastroenteritis. We found the slower regime giving rehydration therapy over 8 hours to be safe. For clinicians it was easier to implement than the two-stage Plan C regime. Time correct signs of dehydration and hospital stay was similar in the two groups. Future large trials with mortality as the primary endpoint are warranted.

Posted 23/07/2019. Professor Peter Horby and colleagues at the University of Oxford have compiled data from over 6000 patients to provide a comprehensive clinical description of Ebola virus disease. The team also assessed the quality of the published data and found it to be partial, overlapping, and in many instance non-comparable. For high-threat diseases such as Ebola, the authors recommend the establishment of global, anonymised patient registries as a resource for improving patient care.