Table 1.
General characteristics
| |
Severe P. falciparum |
Non-severe P. falciparum |
Non-falciparum |
P value |
|---|---|---|---|---|
| n=61 | n=259 | n=120 | ||
|
Demographics |
|
|
|
|
| Age, years |
44 (4–70) |
39 (11–78) |
36 (15–77) |
0.0005* |
| Male/female, n (%) |
39 (64%)/ 22 (36%) |
191 (74%) / 68 (26%) |
83 (69%)/37 (31%) |
NS# |
|
Immunity to P. falciparum |
|
|
|
0.0029# |
| Non-immune |
42 (69%) |
123 (47%) |
N/A |
|
| Partially immune |
19 (31%) |
118 (46%) |
N/A |
|
| Semi-immune |
0 (0%) |
3 (1%) |
N/A |
|
| Unknown |
0 (0%) |
16 (6%) |
N/A |
|
|
Continent of acquisition |
|
|
|
NS# |
| Africa, n (%) |
56 (92%) |
240 (93%) |
42 (35%) |
|
| Asia, n (%) |
3 (5%) |
11 (4%) |
50 (42%) |
|
| South and Central America, n (%) |
1 (2%) |
5 (2%) |
26 (22%) |
|
| Unknown, n (%) |
1 (2%) |
3 (1%) |
2 (2%) |
|
|
Duration of signs/symptoms |
|
|
|
0.007# |
| <8 days, n (%) |
38 (62%) |
177 (68%) |
58 (48%) |
|
| 8-14 days, n (%) |
17 (28%) |
45 (17%) |
24 (20%) |
|
| 15-28 days, n (%) |
2 (3%) |
20 (8%) |
11 (9%) |
|
| >28 days, n (%) |
0 (0%) |
5 (2%) |
8 (7%) |
|
| Unknown, n (%) |
4 (7%) |
12 (5%) |
19 (16%) |
|
|
Use of malaria chemoprophylaxis |
|
|
|
<0.0001# |
| No chemoprophylaxis, n (%) |
49 (80%) |
182 (70%) |
51 (43%) |
|
| Inadequate use, n (%) |
8 (13%) |
46 (18%) |
15 (13%) |
|
| Adequate use, n (%) |
2 (3%) |
20 (8%) |
42 (35%) |
|
| Unknown, n (%) |
2 (3%) |
11 (4%) |
12 (10%) |
|
|
Vital signs on admission |
|
|
|
|
| Body temperature, °C |
38.4 (35.7-41.2) |
38.5 (35.5-41.0) |
38.9 (36.0-41.2) |
NS* |
| Pulse rate, beats per minute |
103 (50–150) |
90 (45–140) |
90 (58–138) |
0.0005* |
| Systolic blood pressure, mm Hg |
117 (80–160) |
120 (73–185) |
120 (90–196) |
N.T. |
| Impaired consciousness (GCS<15), n (%) |
8 (13%) |
1 (0%) |
0 (0%) |
N.T. |
| Coma (GCS≤11), n (%) |
3 (5%) |
0 (0%) |
0 (0%) |
N.T. |
|
Laboratory data on admission |
|
|
|
|
| Haemoglobin, mmol/L |
7.8 (2.5-10.9) |
8.4 (4.0-11.1) |
8.2 (4.6-11.2) |
N.T. |
| Thrombocytes, × 109/L |
39 (3–188) |
101 (18–293) |
95 (10–292) |
<0.0001* |
| C-reactive protein, mg/L |
182 (65–476) |
85 (5–320) |
71 (14–348) |
<0.0001* |
| Serum creatinine, μmol/L |
114 (39–1081) |
93 (47–238) |
90 (53–255) |
N.T. |
| Serum sodium, mmol/L |
131 (115–146) |
135 (119–145) |
135 (124–148) |
<0.0001* |
| Lactate dehydrogenase, U/L |
485 (139–2038) |
268 (118–947) |
246 (127–775) |
<0.0001* |
| Total bilirubin, μmol/L |
53 (13–416) |
22 (4–164) |
22 (3–99) |
N.T. |
| Plasma lactate, mmol/L |
2.3 (0.6-6.2) |
1.4 (0.5-4.6) |
1.3 (0.6-4.0) |
<0.0001* |
|
Leukocyte counts |
|
|
|
|
| Total leukocyte count, × 109/L |
6.9 (2.5-18.5) |
4.9 (1.3-13.4) |
5.3 (1.9-15.3) |
<0.0001* |
| Neutrophil count, × 109/L |
3.6 (0.6-10.4) |
3.1 (0.4-11.0) |
3.2 (1.0-11.6) |
0.0064* |
| Neutrophil count% |
60 (19–85) |
64 (13–91) |
64 (20–88) |
NS* |
| Lymphocyte count, × 109/L |
1.0 (0.2-4.2) |
0.9 (0.1-5.0) |
1.1 (0.3-6.1) |
NS* |
| Lymphocyte count % |
15 (4–45) |
19 (2–74) |
21 (5–74) |
0.0036* |
| NLCR |
3.5 (0.7-17.0) |
3.3 (0.2-46) |
2.8 (0.3-17.6) |
NS* |
|
Parasite count |
|
|
|
|
| P.falciparum load (asexual parasites/μL) |
230,000 (520–1,380,600) |
4,288 (2–208,000) |
N/A |
N.T. |
| Presence of P. falciparum schizonts%) |
33 (54%) |
11 (4%) |
N/A |
<0.0001^ |
|
Concomitant infection |
|
|
|
|
| All concomitant infections |
8 (13%) |
11 (4%) |
10 (8%) |
<0.0001# |
| Concomitant bacterial infection | 5 (8%) | 3 (1%) | 2 (2%) | 0.004# |
* Comparison of 3 groups using the Kruskal Wallis test, # Comparison of 3 groups using the Chi-Square Test, ^ Comparison of 2 groups using Fisher’s Exact test. Parameters that are included in the modified WHO severity criteria for severe falciparum malaria were not tested (N.T.).