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Previous Volume 332:1399-1404 May 25, 1995 Number 21 Next

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ABSTRACT

Background About 90 percent of the deaths from malaria are in African children, but criteria to guide the recognition and management of severe malaria have not been validated in them.

Methods We conducted a prospective study of all children admitted to the pediatric ward of a Kenyan district hospital with a primary diagnosis of malaria. We calculated the frequency and mortality rate for each of the clinical and laboratory criteria in the current World Health Organization (WHO) definition of severe malaria, and then used logistic-regression analysis to identify the variables with the greatest prognostic value.

Results We studied 1844 children (mean age, 26.4 months) with a primary diagnosis of malaria. Not included were 18 children who died on arrival and 4 who died of other causes. The mortality rate was 3.5 percent (95 percent confidence interval, 2.7 to 4.3 percent), and 84 percent of the deaths occurred within 24 hours of admission. Logistic-regression analysis identified four key prognostic indicators: impaired consciousness (relative risk, 3.3; 95 percent confidence interval, 1.6 to 7.0), respiratory distress (relative risk, 3.9; 95 percent confidence interval, 2.0 to 7.7), hypoglycemia (relative risk, 3.3; 95 percent confidence interval, 1.6 to 6.7), and jaundice (relative risk, 2.6; 95 percent confidence interval, 1.1 to 6.3). Of the 64 children who died, 54 were among those with impaired consciousness (n = 336; case fatality rate, 11.9 percent) or respiratory distress (n = 251; case fatality rate, 13.9 percent), or both. Hence, this simple bedside index identified 84.4 percent of the fatal cases, as compared with the 79.7 percent identified by the current WHO criteria.

Conclusions In African children with malaria, the presence of impaired consciousness or respiratory distress can identify those at high risk for death.

Source Information

From the Kenya Medical Research Institute–Clinical Research Centre, Kilifi Unit, Kilifi, Kenya (K.M., D.F., C.W., I.M., M.W., V.M., C.N., P. Winstanley, P. Warn, N.P., G.P., R.S.); and the Nuffield Department of Clinical Medicine (K.M., D.F., P. Winstanley, P. Warn, G.P., R.S.) and the Department of Paediatrics (C.N.), Oxford University, John Radcliffe Hospital, Headington, Oxford, United Kingdom.

Address reprint requests to Dr. marsh at the KEMRI Unit, P.O. Box 230, Kilifi, Kenya.

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• Reyburn, H., Mbatia, R., Drakeley, C., Bruce, J., Carneiro, I., Olomi, R., Cox, J., Nkya, W. M. M. M., Lemnge, M., Greenwood, B. M., Riley, E. M. (2005). Association of Transmission Intensity and Age With Clinical Manifestations and Case Fatality of Severe Plasmodium falciparum Malaria. JAMA 293: 1461-1470 [Abstract] [Full Text]  
• Whitty, C. J M, Ansah, E., Reyburn, H. (2005). Treating severe malaria. BMJ 330: 317-318 [Full Text]  
• Berkley, J. A., Lowe, B. S., Mwangi, I., Williams, T., Bauni, E., Mwarumba, S., Ngetsa, C., Slack, M. P.E., Njenga, S., Hart, C. A., Maitland, K., English, M., Marsh, K., Scott, J. A. G. (2005). Bacteremia among Children Admitted to a Rural Hospital in Kenya. NEJM 352: 39-47 [Abstract] [Full Text]  
• Etard, J.-F., Le Hesran, J.-Y., Diallo, A., Diallo, J.-P., Ndiaye, J.-L., Delaunay, V. (2004). Childhood mortality and probable causes of death using verbal autopsy in Niakhar, Senegal, 1989-2000. Int J Epidemiol 33: 1286-1292 [Abstract] [Full Text]  
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• Rogier, C, Gerardin, P, Imbert, P (2004). Thrombocytopenia is predictive of lethality in severe childhood falciparum malaria. Arch. Dis. Child. 89: 795-796 [Full Text]  
• Chang, K.-H., Tam, M., Stevenson, M. M. (2004). Inappropriately low reticulocytosis in severe malarial anemia correlates with suppression in the development of late erythroid precursors. Blood 103: 3727-3735 [Abstract] [Full Text]  
• D'Alessandro, U. (2004). Treating severe and complicated malaria. BMJ 328: 155-155 [Full Text]  
• PONGPONRATN, E., TURNER, G. D. H., DAY, N. P. J., PHU, N. H., SIMPSON, J. A., STEPNIEWSKA, K., MAI, N. T. H., VIRIYAVEJAKUL, P., LOOAREESUWAN, S., HIEN, T. T., FERGUSON, D. J. P., WHITE, N. J. (2003). AN ULTRASTRUCTURAL STUDY OF THE BRAIN IN FATAL PLASMODIUM FALCIPARUM MALARIA. Am J Trop Med Hyg 69: 345-359 [Abstract] [Full Text]  
• Naqvi, R., Ahmad, E., Akhtar, F., Naqvi, A., Rizvi, A. (2003). Outcome in severe acute renal failure associated with malaria. Nephrol Dial Transplant 18: 1820-1823 [Abstract] [Full Text]  
• LOPEZ-VELEZ, R., HUERGA, H., TURRIENTES, M. C. (2003). INFECTIOUS DISEASES IN IMMIGRANTS FROM THE PERSPECTIVE OF A TROPICAL MEDICINE REFERRAL UNIT. Am J Trop Med Hyg 69: 115-121 [Abstract] [Full Text]  
• Osier, F H A, Berkley, J A, Ross, A, Sanderson, F, Mohammed, S, Newton, C R J C (2003). Abnormal blood glucose concentrations on admission to a rural Kenyan district hospital: prevalence and outcome. Arch. Dis. Child. 88: 621-625 [Abstract] [Full Text]  
• Maitland, K., Levin, M., English, M., Mithwani, S., Peshu, N., Marsh, K., Newton, C.R.J.C. (2003). Severe P. falciparum malaria in Kenyan children: evidence for hypovolaemia. QJM 96: 427-434 [Abstract] [Full Text]  
• Moulin, F, Lesage, F, Legros, A-H, Maroga, C, Moussavou, A, Guyon, P, Marc, E, Gendrel, D (2003). Thrombocytopenia and Plasmodium falciparum malaria in children with different exposures. Arch. Dis. Child. 88: 540-541 [Abstract] [Full Text]  
• Makani, J., Matuja, W., Liyombo, E., Snow, R.W., Marsh, K., Warrell, D.A. (2003). Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description. QJM 96: 355-362 [Abstract] [Full Text]  
• Moore, D. A J, Jennings, R. M, Doherty, T. F, Lockwood, D. N, Chiodini, P. L, Wright, S. G, Whitty, C. J M (2003). Lesson of the week: Assessing the severity of malaria. BMJ 326: 808-809 [Full Text]  
• ZUCKER, J. R., RUEBUSH, T. K. II, OBONYO, C., OTIENO, J., CAMPBELL, C. C. (2003). THE MORTALITY CONSEQUENCES OF THE CONTINUED USE OF CHLOROQUINE IN AFRICA: EXPERIENCE IN SIAYA, WESTERN KENYA. Am J Trop Med Hyg 68: 386-390 [Abstract] [Full Text]  
• Berkley, J A, Ross, A, Mwangi, I, Osier, F H A, Mohammed, M, Shebbe, M, Lowe, B S, Marsh, K, Newton, C R J C (2003). Prognostic indicators of early and late death in children admitted to district hospital in Kenya: cohort study. BMJ 326: 361-361 [Abstract] [Full Text]  
• Watt, G., Jongsakul, K., Ruangvirayuth, R. (2002). A pilot study of N-acetylcysteine as adjunctive therapy for severe malaria. QJM 95: 285-290 [Abstract] [Full Text]  
• Weatherall, D. J., Miller, L. H., Baruch, D. I., Marsh, K., Doumbo, O. K., Casals-Pascual, C., Roberts, D. J. (2002). Malaria and the Red Cell. ASH Education Book 2002: 35-57 [Abstract] [Full Text]  
• Chang, W.-L., Jones, S. P., Lefer, D. J., Welbourne, T., Sun, G., Yin, L., Suzuki, H., Huang, J., Granger, D. N., van der Heyde, H. C. (2001). CD8+-T-Cell Depletion Ameliorates Circulatory Shock in Plasmodium berghei-Infected Mice. Infect. Immun. 69: 7341-7348 [Abstract] [Full Text]  
• van Thien, H., Ackermans, M.T., Dekker, E., Chien, V.O. T., Le, T., Endert, E., Kager, P.A., Romijn, J.A., Sauerwein, H.P. (2001). Glucose production and gluconeogenesis in adults with cerebral malaria. QJM 94: 709-715 [Abstract] [Full Text]  
• Urban, B. C., Mwangi, T., Ross, A., Kinyanjui, S., Mosobo, M., Kai, O., Lowe, B., Marsh, K., Roberts, D. J. (2001). Peripheral blood dendritic cells in children with acute Plasmodium falciparum malaria. Blood 98: 2859-2861 [Abstract] [Full Text]  
• Urban, B. C., Willcox, N., Roberts, D. J. (2001). A role for CD36 in the regulation of dendritic cell function. Proc. Natl. Acad. Sci. USA 10.1073/pnas.151028698v1 [Abstract] [Full Text]  
• Pain, A., Ferguson, D. J. P., Kai, O., Urban, B. C., Lowe, B., Marsh, K., Roberts, D. J. (2001). Platelet-mediated clumping of Plasmodium falciparum-infected erythrocytes is a common adhesive phenotype and is associated with severe malaria. Proc. Natl. Acad. Sci. USA 98: 1805-1810 [Abstract] [Full Text]  
• Brabin, B. J., Premji, Z., Verhoeff, F. (2001). An Analysis of Anemia and Child Mortality. J. Nutr. 131: 636S-648 [Abstract] [Full Text]  
• Greenberg, P. L., Gordeuk, V., Issaragrisil, S., Siritanaratkul, N., Fucharoen, S., Ribeiro, R. C. (2001). Major Hematologic Diseases in the Developing World-- New Aspects of Diagnosis and Management of Thalassemia, Malarial Anemia, and Acute Leukemia. ASH Education Book 2001: 479-498 [Abstract] [Full Text]  
• Newton, C. R J C, Hien, T. T., White, N. (2000). NEUROLOGICAL ASPECTS OF TROPICAL DISEASE: Cerebral malaria. J. Neurol. Neurosurg. Psychiatry 69: 433-441 [Abstract] [Full Text]  
• Agarwal, A., Guindo, A., Cissoko, Y., Taylor, J. G., Coulibaly, D., Kone, A., Kayentao, K., Djimde, A., Plowe, C. V., Doumbo, O., Wellems, T. E., Diallo, D. (2000). Hemoglobin C associated with protection from severe malaria in the Dogon of Mali, a West African population with a low prevalence of hemoglobin S. Blood 96: 2358-2363 [Abstract] [Full Text]  
• Berkley, J.A., Mwangi, I., Mellington, F., Mwarumba, S., Marsh, K. (1999). Cerebral malaria versus bacterial meningitis in children with impaired consciousness. QJM 92: 151-157 [Abstract] [Full Text]  
• Pradines, B., Tall, A., Fusai, T., Spiegel, A., Hienne, R., Rogier, C., Trape, J. F., Le Bras, J., Parzy, D. (1999). In Vitro Activities of Benflumetol against 158 Senegalese Isolates of Plasmodium falciparum in Comparison with Those of Standard Antimalarial Drugs. Antimicrob. Agents Chemother. 43: 418-420 [Abstract] [Full Text]  
• White, D. J., Talarico, J., Chang, H.-G., Birkhead, G. S., Heimberger, T., Morse, D. L. (1998). Human Babesiosis in New York State: Review of 139 Hospitalized Cases and Analysis of Prognostic Factors. Arch Intern Med 158: 2149-2154 [Abstract] [Full Text]  
• Scholander, C., Carlson, J., Kremsner, P. G., Wahlgren, M. (1998). Extensive Immunoglobulin Binding of Plasmodium falciparum-Infected Erythrocytes in a Group of Children with Moderate Anemia. Infect. Immun. 66: 361-363 [Abstract] [Full Text]  
• Dekker, E., Hellerstein, M. K., Romijn, J. A., Neese, R. A., Peshu, N., Endert, E., Marsh, K., Sauerwein, H. P. (1997). Glucose Homeostasis in Children with Falciparum Malaria: Precursor Supply Limits Gluconeogenesis and Glucose Production. J. Clin. Endocrinol. Metab. 82: 2514-2521 [Abstract] [Full Text]  
• English, M., New, L., Peshu, N., Marsh, K. (1996). Video assessment of simple respiratory signs. BMJ 313: 1527-1528 [Full Text]  
• White, N.J. (1996). The Treatment of Malaria. NEJM 335: 800-806 [Full Text]  
• van Hensbroek, M. B., Onyiorah, E., Jaffar, S., Schneider, G., Palmer, A., Frenkel, J., Enwere, G., Forck, S., Nusmeijer, A., Bennett, S., Greenwood, B., Kwiatkowski, D. (1996). A Trial of Artemether or Quinine in Children with Cerebral Malaria. NEJM 335: 69-75 [Abstract] [Full Text]  
• Newton, C.R.J.C. (1996). Cerebral Malaria in Children. J Child Neurol 11: 257-257  
• Taylor, T.E., Molyneux, M.E. (1995). Something New Out of Africa. NEJM 332: 1441-1442 [Full Text]  
• Urban, B. C., Willcox, N., Roberts, D. J. (2001). A role for CD36 in the regulation of dendritic cell function. Proc. Natl. Acad. Sci. USA 98: 8750-8755 [Abstract] [Full Text]