Table 1.
Clinical features at presentation and initial investigations by outcome
| All (n=513) | Survived (n=419) | Died (n=94) |
Odds ratio (95% CI)* |
|||
|---|---|---|---|---|---|---|
| Unadjusted | Adjusted | |||||
| Characteristics | ||||||
| Male sex | 281 (55%) | 225 (54%) | 56 (60%) | 1·3 (0·8–2·0) | 1·2 (0·6–2·0) | |
| Age (months) | 24 (7–51) | 24 (7–48) | 24 (9–72) | .. | .. | |
| Seizures | 204 (40%) | 161 (38%) | 43 (46%) | 1·3 (0·9–2·1) | 2·3 (0·7–8·1) | |
| Unconsciousness | 121 (24%) | 91 (22%) | 30 (32%) | 1·7 (1·0–2·7)† | 1·0 (0·4–2·3) | |
| Fever ≥3 days | 188 (37%) | 153 (37 %) | 35 (37%) | .. | .. | |
| Vomiting | 70 (14%) | 57 (14 %) | 13 (14%) | 1·3 (0·6–2·8) | .. | |
| Diarrhoea | 40 (8%) | 32 (8%) | 8 (8%) | 1·4 (0·6–3·3) | .. | |
| Runny nose | 41 (8%) | 35 (8 %) | 6 (6%) | 1·0 (0·4–2·7) | .. | |
| Headache | 36 (7%) | 33 (8%) | 3 (3%) | 0·9 (0·6–1·4) | .. | |
| Examination | ||||||
| Temperature ≥39°C | 48 (9%) | 39 (9%) | 9 (10%) | 1·0 (0·5–2·2) | 0·4 (0·1–1·3) | |
| Deep coma | 144 (28%) | 93 (22%) | 51 (54%) | 4·2 (2·6–6·6)† | 6·7 (3·3–13·8)‡ | |
| Bulging fontanelle | 12 (2%) | 7 (2%) | 5 (5%) | 3·3 (1·0–10·6) | 1·5 (0·4–6·8) | |
| Neck stiffness | 39 (8%) | 31 (7%) | 8 (9%) | 1·2 (0·5–2·6) | 1·5 (0·5–4·7) | |
| Abnormal chest | 26 (5%) | 18 (4%) | 8 (9%) | 2·1 (1·1–3·8)† | 1·6 (0·7–3·8) | |
| Hepatomegaly | 55 (11%) | 43 (10 %) | 12 (13%) | 1·6 (0·7–3·5) | .. | |
| Splenomegaly | 54 (11%) | 47 (11%) | 7 (7%) | 0·7 (0·3–1·6) | .. | |
| Hepatosplenomegaly | 36 (7%) | 31 (7%) | 5 (5%) | 0·8 (0·3–2·1) | .. | |
| Flexor posturing | 9 (2%) | 5 (1%) | 4 (4 %) | 3·7 (1·0–13·9) | 6·7 (0·8–59·3) | |
| Extensor posturing | 6 (1%) | 5 (1 %) | 1 (1%) | 0·9 (0·1–7·7) | 0·2 (0·0–4·0) | |
| Opisthotonus | 12 (2%) | 9 (2%) | 3 (3%) | 1·5 (0·4–5·6) | 0·8 (0·1–6·5) | |
| Observed seizure | 19 (4%) | 13 (3%) | 6 (6%) | 2·0 (0·7–5·2) | 1·4 (0·3–5·7) | |
| Investigations | ||||||
| CSF opening pressure ≥230 cm | 8 (2%) | 3 (1%) | 5 (5%) | 7·8 (1·8–33·0)† | 18·0 (2·7–121·6)‡ | |
| CSF white cell count >5 per μL | 188 (37%) | 152 (36%) | 36 (38%) | 1·4 (0·9–2·4) | 1·6 (0·9–2·8) | |
| HIV status | ||||||
| Positive | 49 (10%) | 32 (8%) | 17 (18%) | 6·6 (2·5–17·4)† | 17·1 (4·3–67·3)‡ | |
| Negative | 91 (18%) | 84 (20%) | 7 (7%) | .. | .. | |
| Not known | 373 (73%) | 303 (72 %) | 70 (74%) | 2·8 (1·2–6·3)† | 8·6 (2·4–30·9)‡ | |
| Malaria parasitaemia and CNS virus | 45 (9%) | 28 (7%) | 17 (18%) | 4·0 (2·0–8·1) | 1·9 (0·7–5·2) | |
| Malaria parasitaemia and no CNS virus | 118 (23%) | 101 (24%) | 17 (18%) | 1·1 (0·6-2·1) | 0·8 (0·4–1·8) | |
| CNS virus but no malaria parasitaemia | 88 (17%) | 62 (15%) | 26 (28%) | 2·8 (1·6–5·0) | 2·3 (1·1–4·9) | |
| No malaria parasitaemia or CNS virus | 260 (51%) | 226 (54%) | 34 (36%) | 1 | 1 | |
Data are n (%) or median (IQR), unless otherwise stated. CSF=cerebrospinal fluid.
*
Comparison of children who survived and died.
†
Significant on univariate analysis.
‡
Significant on multivariate analysis.