Table 3.
Hospitalized Malaria Cases Classified as Severe by the World Health Organization (2015) Broad Severe Malaria Criteria
| Clinical Characteristica | Patients, No. (%) | |||||
|---|---|---|---|---|---|---|
| Plasmodium vivax | Plasmodium falciparum | |||||
| Age ≤15 y (n = 32) | Age >15 y (n = 36) | Total (n = 68) | Age ≤15 y (n = 894) | Age >15 y (n = 588) | Total (n = 1482) | |
| Impaired consciousness | 7 (22) | 2 (6) | 9 (13) | 66 (7) | 117 (20) | 183 (12) |
| Prostration | 7 (22) | 9 (26) | 16 (24) | 220 (25) | 249 (42) | 469 (32) |
| Convulsions | 1 (3) | 3 (8) | 4 (6) | 23 (3) | 10 (2) | 33 (2) |
| Shock | 0 | 4 (11) | 4 (11) | 6 (4) | 28 (5) | 34 (5) |
| Jaundiceb | 0 | 0 | 0 | 29 (3) | 82 (15) | 111 (8) |
| Significant bleeding | 0 | 0 | 0 | 0 | 0 | 0 |
| Pulmonary edema | 14 (44) | 13 (36) | 27 (40) | 123 (14) | 44 (7) | 167 (11) |
| Hypoglycemia | 2 (15) | 2 (11) | 4 (13) | 41 (6) | 15 (4) | 56 (5) |
| Metabolic acidosisc | NA | NA | NA | NA | NA | NA |
| Severe anemiab,d | 7 (22) | 11 (31) | 18 (26) | 103 (12) | 64 (11) | 167 (11) |
| Renal impairmentc | 0 | 0 | 0 | 1 (0.1) | 7 (1) | 8 (0.5) |
| Hyperparasitemia | NA | NA | NA | 607 (68) | 277 (47) | 884 (60) |
Abbreviation: NA, not available.
Nineteen cases with P. vivax and 601 with P. falciparum met ≥2 World Health Organization severity criteria [25].
For P. vivax, parasite density thresholds were not used in the severity definitions of jaundice or anemia.
Laboratory testing was not available. For renal impairment, the discharge diagnosis was used as a proxy.
Severe anemia is defined as hemoglobin ≤5 g/dL or hematocrit ≤15% in children <12 years old (<7 g/dL and <20%, respectively, in adults).