Table 3.
Disease severity and management
| Disease severity and management | Value |
|---|---|
| Case definition | |
| Severe malaria | 21 (21.0%) |
| Uncomplicated malaria | 79 (79.0%) |
| Management setting | |
| Inpatient ICU | 21 (21.0%) |
| Inpatient ward | 64 (64.0%) |
| ED/Outpatient only | 15 (15.0%) |
| LOS days—median (IQR) | |
| All inpatient cases | 3 (2,5) |
| Severe malaria only | 8 (6,10) |
| Complications | |
| ARDS | 10 (10.0%) |
| AKI | 7 (7.0%) |
| Transfusion* | 7 (7.0%) |
| Intubation | 6 (6.0%) |
| QT prolongation | 6 (6.0%) |
| DIC† | 6 (6.0%) |
| Nosocomial infection | 5 (5.0%) |
| Initial treatment | |
| Quinidine gluconate IV | 14 (14.0%) |
| QG IV + doxycycline PO | 10 |
| QG IV + clindamycin PO | 2 |
| QG IV alone until stabilized | 2 |
| Quinine sulfate PO | 24 (24.0%) |
| QS PO + doxycycline PO | 23 |
| QS PO + clindamycin PO | 1 |
| Atovaquone/proguanil | 29 (29.0%) |
| Artemether/lumefantrine | 19 (19.0%) |
| Chloroquine | 8 (8.0%) |
| Mefloquine | 3 (3.0%) |
| Other/unknown | 3 (3.0%) |
| Treatment changed | 24 (24.0%) |
| Reason for treatment change | |
| Treatment failure/persistent parasitemia | 11 (45.8%) |
| QT prolongation | 4 (16.7%) |
| Gastrointestinal intolerance | 3 (12.5%) |
| Non-falciparum diagnosed | 3 (12.5%) |
| Convenience/cost/other | 3 (12.5%) |
AKI = acute kidney injury; ARDS = acute respiratory distress syndrome; DIC = disseminated intravascular coagulation; ED = emergency department; ICU = intensive care unit; LOS = length of stay; QG = quinidine gluconate; QS = quinine sulfate.
* A total of seven patients received packed red blood cell transfusions; of these, two were exchange transfusions and five were supportive transfusions for severe/symptomatic anemia. Exchange transfusions are no longer favored in clinical practice.
† One patient with severe DIC received fresh frozen plasma and platelet transfusions.