Publication: Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital
Issued Date
2011-09-15
Resource Type
ISSN
15376591
10584838
10584838
Other identifier(s)
2-s2.0-80052221188
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Infectious Diseases. Vol.53, No.6 (2011), 548-554
Suggested Citation
George Mtove, Behzad Nadjm, Ilse C E Hendriksen, Ben Amos, Florida Muro, Jim Todd, Hugh Reyburn Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital. Clinical Infectious Diseases. Vol.53, No.6 (2011), 548-554. doi:10.1093/cid/cir471 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/12316
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Title
Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital
Abstract
Background.Lactic acidosis is a consistent predictor of mortality owing to severe infectious disease, but its detection in low-income settings is limited to the clinical sign of "deep breathing" because of the lack of accessible technology for its measurement. We evaluated the use of a point-of-care (POC) diagnostic device for blood lactate measurement to assess the severity of illness in children admitted to a district hospital in Tanzania.Methods.Children between the ages of 2 months and 13 years with a history of fever were enrolled in the study during a period of 1 year. A full clinical history and examination were undertaken, and blood was collected for culture, microscopy, complete blood cell count, and POC measurement of blood lactate and glucose.Results.The study included 3248 children, of whom 164 (5.0%) died; 45 (27.4%) of these had raised levels of blood lactate ( > 5 mmol/L) but no deep breathing. Compared with mortality in children with lactate levels of ≤3 mmol/L, the unadjusted odds of dying were 1.6 (95% confidence interval [CI],.8-3.0), 3.4 (95% CI, 1.5-7.5), and 8.9 (95% CI, 4.7-16.8) in children with blood lactate levels of 3.1-5.0, 5.1-8.0, or > 8.0 mmol/L, respectively. The prevalence of raised lactate levels ( > 5 mmol/L) was greater in children with malaria than in children with nonmalarial febrile illness (P < . 001) although the associated mortality was greater in slide-negative children.Conclusions.POC lactate measurement can contribute to the assessment of children admitted to hospital with febrile illness and can also create an opportunity for more hospitals in resource-poor settings to participate in clinical trials of interventions to reduce mortality associated with hyperlactatemia. © 2011 The Author.