Systemic Lupus seems the most likely underlying diagnosis in a patient with this history.  

Tests - In a patient in or from Africa who has a fever, infection is always a possibility. The attending doctors thought that looking for malaria parasites was an important initial test. She had a high level of parasitaemia with Malaria falciparum.

HIV is another extremely important issue in the region. The incidence of positivity in the population may be 10-15% but in the adult wards at QECH it can be 80%.  She was HIV non-reactive. 

Treatment - Steroids or cytotoxics in this context could have been disastrous.  Her initial treatment according to WHO should be Artemesin, but it is not generally affordable so Quinine is still most commonly used. She responded to treatment and her Hb rose.  

Treatment beyond this point becomes difficult, but almost certainly she has aggressive inflammatory disease in view of the creatinine changes, and will need cyclophosphamide or MMF.  Cost, and the best long term evidence, would usually militate for the former.  

Could this all have been HIV?  SLE-type manifestations may occur in HIV infection, autoimmune phenomena are common in early disease.  Her constellation of typical lupus manifestations would be unusual, but never say never.  Although you might expect the immunosuppression caused by HIV to suppress lupus, there are several reports in the literature of the two conditions occuring together, again probably in early HIV disease, posing problems for lupus therapy until the CD4 count has responded to HAART.   

Classic HIV nephropathy is a common cause of renal disease, though it usually has a more extreme nephrotic phase, and other renal pathologies also occur.  

Further info

• brief notes on HIV nephropathy and lupus nephropathy from Edrep