Table 3.
Comparison of indicators of severity and parasite biomass in uncomplicated and severe malaria when hyperlactatemia redefined as lactate >4 mmol/L.*
| Clinical manifestationa | n (%) | Age (years) GM (95%CI) | Hemoglobin (g/dL) GM (95%CI) | Platelets (×109/L)b GM (95%CI) | Lactate (mmol/L) GM (95%CI) |
Parasitaemia (%) GM (95%CI) | Parasite density (×105 /μL) GM (95%CI) | Plasma PfHRP2 (ng/mL) GM (95%CI) | Circulating parasite biomass (×1010/kg) GM (95%CI) | Total parasite biomass (×1010/kg) GM (95%CI) | Sequestered biomass (×1010/kg)c median (95%CI) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Uncomplicated | 154 (52.0) | 6.68 (6.06–7.36) | 11.34 (11.04–11.66) | 110.6 (99.2–123.4) | 1.95 (1.84–2.07) | 2.88 (2.40–3.46) | 1.23 (1.02–1.49) | 99.1 (82.0–119.6) | 0.995 (0.83–1.20) | 1.09 (0.90–1.33) | 0.06 (−0.16 to 0.35) |
| Severe | 142 (48.0) | 4.29 (3.93–4.69) P < 0.001 |
9.19 (8.79–9.60) P < 0.001 |
64.5 (56.0–74.4) P < 0.001 |
4.66 (4.17–5.21) P < 0.001 |
7.46 (6.18–9.01) P < 0.001 |
2.69 (2.24–3.22) P < 0.001 |
231.4 (189.4–282.8) P < 0.001 |
2.29 (2.09–3.14) P < 0.001 |
2.92 (2.37–3.60) P < 0.001 |
0.22 (−0.14 to 0.79) P = 0.71 |
| SNP | 103 (34.8) | 4.23 (3.81–4.70) P < 0.001 |
8.92 (8.46–9.40) P < 0.001 |
67.8 (57.0–80.6) P < 0.001 |
6.04 (5.59–6.52) P < 0.001 |
8.45 (6.84–10.4) P < 0.001 |
3.00 (2.45–3.66) P < 0.001 |
254.3 (196.9–328.3) P < 0.001 |
2.56 (2.09–3.14) P < 0.001 |
3.26 (2.49–4.25) P < 0.001 |
0.40 (−0.09 to 0.92) P = 0.39 |
| LA | 100 (33.8) | 4.28 (3.84–4.75) P < 0.001 |
8.97 (8.52–9.43) P < 0.001 |
65.7 (55.1–78.3) P < 0.001 |
6.22 (5.79–6.68) P < 0.001 |
8.66 (6.99–10.7) P < 0.001 |
3.10 (2.53–3.80) P < 0.001 |
262.5 (202.0–341.3) P < 0.001 |
2.63 (2.15–3.26) P < 0.001 |
3.36 (2.55–4.41) P < 0.001 |
0.36 (−0.09 to 1.01) P = 0.45 |
GM, geometric mean; 95% CI, 95% confidence interval
*P value for comparison with the uncomplicated malaria group using the unpaired t-test on log10-transformed data, when n ≥ 3, unless specified otherwise. Only tests with P ≤ 0.029 have a false discovery rate of 5% or less using the Benjamini and Hochberg method to control for multiple comparisons and are considered significant (P value in bold type).
Severe malaria cases were considered together, or in subgroups: SNP, severe non-prostrated, and LA, hyperlactataemia.
Platelet count was not available for four subjects with prostration.
P values for comparison with the uncomplicated malaria group using the likelihood-ratio test when n > 5.