Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations
Severe malaria caused by Plasmodium falciparum is difficult to diagnose accurately in children in high-transmission settings. Using data from 2649 pediatric and adult patients enrolled in four studies of severe illness in three countries (Bangladesh, Kenya, and Uganda), we fitted Bayesian latent cla...
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th-mahidol.857112023-06-19T00:47:17Z Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations Watson J.A. Mahidol University Medicine Severe malaria caused by Plasmodium falciparum is difficult to diagnose accurately in children in high-transmission settings. Using data from 2649 pediatric and adult patients enrolled in four studies of severe illness in three countries (Bangladesh, Kenya, and Uganda), we fitted Bayesian latent class models using two diagnostic markers: the platelet count and the plasma concentration of P. falciparum histidine-rich protein 2 (PfHRP2). In severely ill patients with clinical features consistent with severe malaria, the combination of a platelet count of ≤150,000/υl and a plasma PfHRP2 concentration of ≥1000 ng/ml had an estimated sensitivity of 74% and specificity of 93% in identifying severe falciparum malaria. Compared with misdiagnosed children, pediatric patients with true severe malaria had higher parasite densities, lower hematocrits, lower rates of invasive bacterial disease, and a lower prevalence of both sickle cell trait and sickle cell anemia. We estimate that one-third of the children enrolled into clinical studies of severe malaria in high-transmission settings in Africa had another cause of their severe illness. 2023-06-18T17:47:17Z 2023-06-18T17:47:17Z 2022-07-20 Article Science Translational Medicine Vol.14 No.654 (2022) 10.1126/scitranslmed.abn5040 19466242 19466234 35857826 2-s2.0-85131723581 https://repository.li.mahidol.ac.th/handle/123456789/85711 SCOPUS |
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Medicine Watson J.A. Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations |
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Severe malaria caused by Plasmodium falciparum is difficult to diagnose accurately in children in high-transmission settings. Using data from 2649 pediatric and adult patients enrolled in four studies of severe illness in three countries (Bangladesh, Kenya, and Uganda), we fitted Bayesian latent class models using two diagnostic markers: the platelet count and the plasma concentration of P. falciparum histidine-rich protein 2 (PfHRP2). In severely ill patients with clinical features consistent with severe malaria, the combination of a platelet count of ≤150,000/υl and a plasma PfHRP2 concentration of ≥1000 ng/ml had an estimated sensitivity of 74% and specificity of 93% in identifying severe falciparum malaria. Compared with misdiagnosed children, pediatric patients with true severe malaria had higher parasite densities, lower hematocrits, lower rates of invasive bacterial disease, and a lower prevalence of both sickle cell trait and sickle cell anemia. We estimate that one-third of the children enrolled into clinical studies of severe malaria in high-transmission settings in Africa had another cause of their severe illness. |
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Mahidol University Watson J.A. |
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Watson J.A. |
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Watson J.A. |
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Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations |
title_short |
Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations |
title_full |
Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations |
title_fullStr |
Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations |
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Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations |
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improving the diagnosis of severe malaria in african children using platelet counts and plasma pfhrp2 concentrations |
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2023 |
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https://repository.li.mahidol.ac.th/handle/123456789/85711 |
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