Management Outcomes of Cerebral Malaria in Children at Federal Medical Centre Lokoja, Kogi State, North Central Nigeria

Cerebral malaria remains one of the most severe complications of Plasmodium falciparum infection in children, carrying substantial mortality and long-term neurological morbidity. This retrospective study examines management approaches and outcomes of paediatric cerebral malaria at Federal Medical Centre Lokoja, Kogi State, North Central Nigeria, over a four-year period from 2020 to 2023. Medical records of 186 children aged six months to 12 years fulfilling WHO criteria for cerebral malaria were reviewed. Variables extracted included clinical presentation, blood glucose on admission, antimalarial regimen used, adjunct treatments, neurological sequelae, and outcome at discharge. Artesunate-based therapy was used as first-line treatment in 79.0% of cases. Hypoglycaemia on admission was documented in 38.2% of patients and was associated with significantly higher mortality (p less than 0.01). Convulsions occurred in 81.7% of cases. Overall case fatality rate was 18.3%. Neurological sequelae at discharge, including cognitive impairment, hemiplegia, and persistent seizures, were recorded in 24.8% of survivors. Delayed presentation beyond 24 hours was associated with a threefold increase in mortality risk. Hypoglycaemia management was inconsistent in 31.2% of documented cases. The study recommends mandatory blood glucose monitoring on admission, standardised cerebral malaria management protocols, and structured neurological follow-up for survivors to assess and manage post-discharge sequelae. Keywords: cerebral malaria, paediatric, neurological sequelae, Lokoja, North Central Nigeria.