Lorenz Von SeidleinRasaq OlaosebikanIlse C.E. HendriksenSue J. LeeOlanrewaju Timothy AdedoyinTsiri AgbenyegaSamuel Blay NguahKalifa BojangJacqueline L. DeenJennifer EvansCaterina I. FanelloErmelinda GomesAlínia José PedroCatherine KahabukaCorine KaremaEsther KivayaKathryn MaitlandOlugbenga A. MokuoluGeorge MtoveJuliet Mwanga-AmumpaireBehzad NadjmMargaret NansumbaWirichada Pan NgumMarie A. OnyambokoHugh ReyburnTharisara SakulthaewKamolrat SilamutAntoinette K. TshefuNoella UmulisaSamwel GesaseNicholas P.J. DayNicholas J. WhiteArjen M. DondorpMenzies School of Health ResearchRoyal Victoria Teaching HospitalMedical Research Council Laboratories GambiaMahidol UniversityUniversity of IlorinKomfo Anokye Teaching HospitalHospital Central da BeiraMagunga District HospitalRwamagana Hospital and Nyanza HospitalKilifi District General HospitalTeule District HospitalLondon School of Hygiene &amp; Tropical MedicineMbarara Teaching HospitalKingasani Health Centre2018-06-112018-06-112012-04-15Clinical Infectious Diseases. Vol.54, No.8 (2012), 1080-109015376591105848382-s2.0-84859057439https://repository.li.mahidol.ac.th/handle/123456789/14838Background. Data from the largest randomized, controlled trial for the treatment of children hospitalized with severe malaria were used to identify such predictors of a poor outcome from severe malaria.Methods.African children ( < 15 years) with severe malaria participated in a randomized comparison of parenteral artesunate and parenteral quinine in 9 African countries. Detailed clinical assessment was performed on admission. Parasite densities were assessed in a reference laboratory. Predictors of death were examined using a multivariate logistic regression model. Results. Twenty indicators of disease severity were assessed, out of which 5 (base deficit, impaired consciousness, convulsions, elevated blood urea, and underlying chronic illness) were associated independently with death. Tachypnea, respiratory distress, deep breathing, shock, prostration, low pH, hyperparasitemia, severe anemia, and jaundice were statistically significant indicators of death in the univariate analysis but not in the multivariate model. Age, glucose levels, axillary temperature, parasite density, heart rate, blood pressure, and blackwater fever were not related to death in univariate models. Conclusions. Acidosis, cerebral involvement, renal impairment, and chronic illness are key independent predictors for a poor outcome in African children with severe malaria. Mortality is markedly increased in cerebral malaria combined with acidosis.Clinical Trial Registration.ISRCTN50258054. © 2012 The Author.Mahidol UniversityMedicineArticleSCOPUS10.1093/cid/cis034