Abstract

Pediatric severe malaria, compounded by HIV co-infection, presents a complex clinical challenge, often necessitating blood transfusion for severe anemia. However, determining optimal transfusion thresholds for this population remains elusive. This review synthesizes current evidence and guidelines regarding transfusion thresholds in pediatric severe malaria, particularly in the context of HIV co-infection. The paper explores factors influencing transfusion decisions, including disease severity, hemoglobin levels, and transfusion-related complications. Additionally, we address the potential neurocognitive effects of transfusion and highlight the need for cautious management. While existing guidelines offer recommendations based on disease severity and hemoglobin levels, tailored approaches considering neurocognitive implications and transfusion-related risks are essential. Future research should focus on establishing evidence-based transfusion thresholds and assessing their impact on clinical outcomes in pediatric severe malaria cases with HIV co-infection. Such efforts will improve transfusion strategies and optimize outcomes for this vulnerable population.