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Title: Clinical features and outcome of severe malaria in gambian children
Authors: D. Waller
S. Krishna
J. Crawley
K. Miller
F. Nosten
D. Chapman
F. O. Ter Kuile
C. Craddock
C. Berry
P. A.H. Holloway
D. Brewster
B. M. Greenwood
N. J. White
John Radcliffe Hospital
Centers for Disease Control and Prevention
University of Washington, Seattle
Mahidol University
Academic Medical Centre, University of Amsterdam
University of Amsterdam
Keywords: Medicine
Issue Date: 1-Jan-1995
Citation: Clinical Infectious Diseases. Vol.21, No.3 (1995), 577-587
Abstract: The clinical and laboratory features of severe falciparum malaria in 180 Gambian children were studied between 1985 and 1989. Of the 180 children, 118 (66%) presented with seizures, 77 (43%) had cerebral malaria, 35 (20%) had witnessed seizures after admission, 29 (16%) were hypoglycemic, and 27 (15%) died. Respiratory distress was a common harbinger of a fatal outcome. The differences in admission parasite counts in the blood, hematocrit, and opening cerebrospinal pressures for patients who died and survivors were not significant. A multiple logistic regression model identified neurological status (coma, particularly if associated with extensor posturing), stage of parasite development on the peripheral blood film, pulse rate of >150 or respiratory rate of >50, hypoglycemia, and hyperlactatemia (plasma lactate level, >5 mmol/L) as independent indicators of a fatal outcome. Biochemical evidence of hepatic and renal dysfunction was an additional marker of a poor prognosis, but, in contrast to severe malaria in adults, none of these children with severe malaria had acute renal failure. © 1995 by The University of Chicago. All rights reserved.
ISSN: 15376591
Appears in Collections:Scopus 1991-2000

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