Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations
Issued Date
2022-07-20
Resource Type
ISSN
19466234
eISSN
19466242
Scopus ID
2-s2.0-85131723581
Pubmed ID
35857826
Journal Title
Science Translational Medicine
Volume
14
Issue
654
Rights Holder(s)
SCOPUS
Bibliographic Citation
Science Translational Medicine Vol.14 No.654 (2022)
Suggested Citation
Watson J.A., Uyoga S., Wanjiku P., Makale J., Nyutu G.M., Mturi N., George E.C., Woodrow C.J., Day N.P.J., Bejon P., Opoka R.O., Dondorp A.M., John C.C., Maitland K., Williams T.N., White N.J. Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations. Science Translational Medicine Vol.14 No.654 (2022). doi:10.1126/scitranslmed.abn5040 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85711
Title
Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations
Other Contributor(s)
Abstract
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.