Objectives: The aim of this study was to evaluate the management of severe malaria at the Niamey National Hospital (NNH).

Patients and Methods: Prospective study was conducted in intensive care unit (ICU) of the Niamey National Hospital, from September, 2020 to October, 2021. Data collected included: age, sex, medical history, temperature (°C), oxygen saturation (%), neurological, respiratory and circulatory distress, biological exams, treatment, prognostic and the mortality. The data was processed and analyzed by Word 2019 and Epi infos 7.2.

Results: The sample included thirty-six patients admitted in intensive care unit (ICU) for severe malaria. Hospital prevalence was 9.54%. The mean age of patients was 20.69 years with extremes of 3 years and 47 years; sex ratio was 1.25 (M/F). In this study 78% of our patients had no médical history. Patients had fever in 25% of cases. Neurological signs were dominated by convulsions with 52.77%. Clinically patients had respiratory distress 25% and circulatory distress represent 42% of cases. Hepatomegaly was present in 22% of cases and icterus for 10.1%. The average parasite density was 320 elements/μL with extremes ranging from 120 to 14800 parasites/μL. Severe anemia was encountered in 47% of cases and 89 % of patients have ionic disorders. Hyperparasitemia was found for 19% of cases and acute renal failure in 11%. Neurological form dominated with 64% of cases. All of our patients had received intravenous artesunate. Evolution was favorable in 89% of cases and the mortality rate was 8%. The average length of hospital stay in intensive care was 6.69 days.

Conclusion: Severe malaria is frequent in intensive care, nevertheless it’s clinical and paraclinical manifestations are serious, constituting life-threatening distress. The trend was favourable in the majority of cases.