D. WallerS. KrishnaJ. CrawleyK. MillerF. NostenD. ChapmanF. O. Ter KuileC. CraddockC. BerryP. A.H. HollowayD. BrewsterB. M. GreenwoodN. J. WhiteJohn Radcliffe HospitalCenters for Disease Control and PreventionUniversity of Washington, SeattleMahidol UniversityAcademic Medical Centre, University of AmsterdamUniversity of Amsterdam2018-07-042018-07-041995-01-01Clinical Infectious Diseases. Vol.21, No.3 (1995), 577-58715376591105848382-s2.0-0029166522https://repository.li.mahidol.ac.th/handle/20.500.14594/17499The 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.Mahidol UniversityMedicineArticleSCOPUS10.1093/clinids/21.3.577