Newton, PN;
Stepniewska, K;
Dondorp, A;
Silamut, K;
Chierakul, W;
Krishna, S;
Davis, TM;
Suputtamongkol, Y;
Angus, B;
Pukrittayakamee, S;
et al.
Newton, PN; Stepniewska, K; Dondorp, A; Silamut, K; Chierakul, W; Krishna, S; Davis, TM; Suputtamongkol, Y; Angus, B; Pukrittayakamee, S; Ruangveerayuth, R; Hanson, J; Day, NP; White, NJ
(2013)
Prognostic indicators in adults hospitalized with falciparum malaria in Western Thailand.
Malaria Journal, 12 (229).
pp. 1-14.
ISSN 1475-2875
https://doi.org/10.1186/1475-2875-12-229
SGUL Authors: Krishna, Sanjeev
![[img]](https://openaccess.sgul.ac.uk/102147/1.hassmallThumbnailVersion/1475-2875-12-229.pdf) ![](https://openaccess.sgul.ac.uk/102147/1.haspreviewThumbnailVersion/1475-2875-12-229.pdf) Preview |
|
["document_typename_application/pdf; charset=binary" not defined]
Published Version
Download (388kB)
| Preview
|
Abstract
Background: Severe malaria remains a major cause of death and morbidity amongst adults in the Asiatic tropics.
Methods: A retrospective analysis of the clinical and laboratory data of 988 adult patients, hospitalized with
Plasmodium falciparum malaria and prospectively recruited to malaria studies in western Thailand between 1986
and 2002, was performed to assess the factors associated with a fatal outcome. Different severity scores and
classifications for defining severe malaria were compared and, using multiple logistic regression, simple models for
predicting mortality developed.
Results: The proportion of patients fulfilling the WHO 2000 definition of severe malaria was 78.1%, and their mortality
was 10%. Mortality in patients given parenteral artesunate or artemether (16/317, 5%) was lower than in those given
parenteral quinine (59/442, 13%) (P < 0.001). Models using parameter sets based on WHO 1990, 2000 and Adapted AQ
criteria plus blood smear parasite-stage assessment gave the best mortality prediction. A malaria prognostic index (MPI), derived from the dataset using five clinical or laboratory variables gave similar prognostic accuracy.
Conclusions: The mortality of severe malaria in adults has fallen and the switch from quinine to artesunate has probably been an important contributor. Prognostic indices based on WHO 2000 definitions, and other simpler indices based on fewer variables, provide clinically useful predictions of outcome in Asian adults with severe malaria.
Item Type: |
Article
|
Additional Information: |
Copyright ©2013 Newton et al.; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: |
Science & Technology, Life Sciences & Biomedicine, Parasitology, Tropical Medicine, Malaria, Mortality, Thailand, Plasmodium falciparum, Prognosis, ACUTE-RENAL-FAILURE, CEREBRAL MALARIA, RANDOMIZED-TRIAL, AFRICAN CHILDREN, QUININE, ARTESUNATE |
SGUL Research Institute / Research Centre: |
Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: |
Malaria Journal |
ISSN: |
1475-2875 |
Related URLs: |
|
Dates: |
Date | Event |
---|
8 July 2013 | Published |
|
Web of Science ID: |
WOS:000321775000001 |
![](http://ukpmc.ac.uk/resources/uk.bl.ukpmc.web.panels.images.UkpmcFavicon/small_logo.gif) ![](/images/document-pdf.png) |
Download EPMC Full text (PDF)
|
![](http://ukpmc.ac.uk/resources/uk.bl.ukpmc.web.panels.images.UkpmcFavicon/small_logo.gif) |
Download EPMC Full text (HTML)
|
URI: |
https://openaccess.sgul.ac.uk/id/eprint/102147 |
Publisher's version: |
https://doi.org/10.1186/1475-2875-12-229 |
Statistics
Item downloaded times since 02 Apr 2014.
Actions (login required)
![Edit Item](/style/images/action_view.png) |
Edit Item |