Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial
Background. Data from the largest randomized, controlled trial for the treatment of children hospitalized with severe malaria were used to identify such predictors of a poor outcome from severe malaria.Methods.African children ( < 15 years) with severe malaria participated in a randomized compari...
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th-mahidol.148382018-06-11T12:12:42Z Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial Lorenz Von Seidlein Rasaq Olaosebikan Ilse C.E. Hendriksen Sue J. Lee Olanrewaju Timothy Adedoyin Tsiri Agbenyega Samuel Blay Nguah Kalifa Bojang Jacqueline L. Deen Jennifer Evans Caterina I. Fanello Ermelinda Gomes Alínia José Pedro Catherine Kahabuka Corine Karema Esther Kivaya Kathryn Maitland Olugbenga A. Mokuolu George Mtove Juliet Mwanga-Amumpaire Behzad Nadjm Margaret Nansumba Wirichada Pan Ngum Marie A. Onyamboko Hugh Reyburn Tharisara Sakulthaew Kamolrat Silamut Antoinette K. Tshefu Noella Umulisa Samwel Gesase Nicholas P.J. Day Nicholas J. White Arjen M. Dondorp Menzies School of Health Research Royal Victoria Teaching Hospital Medical Research Council Laboratories Gambia Mahidol University University of Ilorin Komfo Anokye Teaching Hospital Hospital Central da Beira Magunga District Hospital Rwamagana Hospital and Nyanza Hospital Kilifi District General Hospital Teule District Hospital London School of Hygiene & Tropical Medicine Mbarara Teaching Hospital Kingasani Health Centre Medicine Background. Data from the largest randomized, controlled trial for the treatment of children hospitalized with severe malaria were used to identify such predictors of a poor outcome from severe malaria.Methods.African children ( < 15 years) with severe malaria participated in a randomized comparison of parenteral artesunate and parenteral quinine in 9 African countries. Detailed clinical assessment was performed on admission. Parasite densities were assessed in a reference laboratory. Predictors of death were examined using a multivariate logistic regression model. Results. Twenty indicators of disease severity were assessed, out of which 5 (base deficit, impaired consciousness, convulsions, elevated blood urea, and underlying chronic illness) were associated independently with death. Tachypnea, respiratory distress, deep breathing, shock, prostration, low pH, hyperparasitemia, severe anemia, and jaundice were statistically significant indicators of death in the univariate analysis but not in the multivariate model. Age, glucose levels, axillary temperature, parasite density, heart rate, blood pressure, and blackwater fever were not related to death in univariate models. Conclusions. Acidosis, cerebral involvement, renal impairment, and chronic illness are key independent predictors for a poor outcome in African children with severe malaria. Mortality is markedly increased in cerebral malaria combined with acidosis.Clinical Trial Registration.ISRCTN50258054. © 2012 The Author. 2018-06-11T05:12:42Z 2018-06-11T05:12:42Z 2012-04-15 Article Clinical Infectious Diseases. Vol.54, No.8 (2012), 1080-1090 10.1093/cid/cis034 15376591 10584838 2-s2.0-84859057439 https://repository.li.mahidol.ac.th/handle/123456789/14838 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84859057439&origin=inward |
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Medicine Lorenz Von Seidlein Rasaq Olaosebikan Ilse C.E. Hendriksen Sue J. Lee Olanrewaju Timothy Adedoyin Tsiri Agbenyega Samuel Blay Nguah Kalifa Bojang Jacqueline L. Deen Jennifer Evans Caterina I. Fanello Ermelinda Gomes Alínia José Pedro Catherine Kahabuka Corine Karema Esther Kivaya Kathryn Maitland Olugbenga A. Mokuolu George Mtove Juliet Mwanga-Amumpaire Behzad Nadjm Margaret Nansumba Wirichada Pan Ngum Marie A. Onyamboko Hugh Reyburn Tharisara Sakulthaew Kamolrat Silamut Antoinette K. Tshefu Noella Umulisa Samwel Gesase Nicholas P.J. Day Nicholas J. White Arjen M. Dondorp Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial |
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Background. Data from the largest randomized, controlled trial for the treatment of children hospitalized with severe malaria were used to identify such predictors of a poor outcome from severe malaria.Methods.African children ( < 15 years) with severe malaria participated in a randomized comparison of parenteral artesunate and parenteral quinine in 9 African countries. Detailed clinical assessment was performed on admission. Parasite densities were assessed in a reference laboratory. Predictors of death were examined using a multivariate logistic regression model. Results. Twenty indicators of disease severity were assessed, out of which 5 (base deficit, impaired consciousness, convulsions, elevated blood urea, and underlying chronic illness) were associated independently with death. Tachypnea, respiratory distress, deep breathing, shock, prostration, low pH, hyperparasitemia, severe anemia, and jaundice were statistically significant indicators of death in the univariate analysis but not in the multivariate model. Age, glucose levels, axillary temperature, parasite density, heart rate, blood pressure, and blackwater fever were not related to death in univariate models. Conclusions. Acidosis, cerebral involvement, renal impairment, and chronic illness are key independent predictors for a poor outcome in African children with severe malaria. Mortality is markedly increased in cerebral malaria combined with acidosis.Clinical Trial Registration.ISRCTN50258054. © 2012 The Author. |
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Menzies School of Health Research |
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Menzies School of Health Research Lorenz Von Seidlein Rasaq Olaosebikan Ilse C.E. Hendriksen Sue J. Lee Olanrewaju Timothy Adedoyin Tsiri Agbenyega Samuel Blay Nguah Kalifa Bojang Jacqueline L. Deen Jennifer Evans Caterina I. Fanello Ermelinda Gomes Alínia José Pedro Catherine Kahabuka Corine Karema Esther Kivaya Kathryn Maitland Olugbenga A. Mokuolu George Mtove Juliet Mwanga-Amumpaire Behzad Nadjm Margaret Nansumba Wirichada Pan Ngum Marie A. Onyamboko Hugh Reyburn Tharisara Sakulthaew Kamolrat Silamut Antoinette K. Tshefu Noella Umulisa Samwel Gesase Nicholas P.J. Day Nicholas J. White Arjen M. Dondorp |
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Article |
author |
Lorenz Von Seidlein Rasaq Olaosebikan Ilse C.E. Hendriksen Sue J. Lee Olanrewaju Timothy Adedoyin Tsiri Agbenyega Samuel Blay Nguah Kalifa Bojang Jacqueline L. Deen Jennifer Evans Caterina I. Fanello Ermelinda Gomes Alínia José Pedro Catherine Kahabuka Corine Karema Esther Kivaya Kathryn Maitland Olugbenga A. Mokuolu George Mtove Juliet Mwanga-Amumpaire Behzad Nadjm Margaret Nansumba Wirichada Pan Ngum Marie A. Onyamboko Hugh Reyburn Tharisara Sakulthaew Kamolrat Silamut Antoinette K. Tshefu Noella Umulisa Samwel Gesase Nicholas P.J. Day Nicholas J. White Arjen M. Dondorp |
author_sort |
Lorenz Von Seidlein |
title |
Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial |
title_short |
Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial |
title_full |
Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial |
title_fullStr |
Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial |
title_full_unstemmed |
Predicting the clinical outcome of severe falciparum malaria in African children: Findings from a large randomized trial |
title_sort |
predicting the clinical outcome of severe falciparum malaria in african children: findings from a large randomized trial |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/14838 |
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1763491087541862400 |