Table 1.
Clinical and demographic characteristics of the study population*.
| Banjul | Blantyre | Kilifi | Kumasi | Lambaréné | Libreville | |
|---|---|---|---|---|---|---|
|
| ||||||
| N = 3,318 | N = 5,358 | N = 6,846 | N = 6,925 | N = 1,784 | N = 1,662 | |
| Age, median (Q1, Q3), months | 32 (18, 51) | 26 (14, 46) | 26 (14, 43) | 24 (12, 42) | 28 (16, 56) | 25 (15, 42) |
| Sex, N (%) Female | 1,617 (48) | 2,493 (46) | 3,188 (46) | 3,113 (45) | 841 (47) | 793 (47 |
| Weight, median (Q1, Q3), kg | 11·0 (9·0, 15·0) | 10·2 (8·4, 13·5) | 9·9 (8·0, 12·6) | 10·0 (8·0, 13·5) | 11·0 (9·0, 15·0) | 11·0 (9·0, 14·0) |
| Weight-for-age, median (Q1, Q3), Z-score | −1·36 (−2·30, −0·50) | −1·22 (−2·19, −0·35) | −1·7 (−2·56, −0·86) | −1·15 (−2·04, −0·35) | −1·01 (−1·84, −0·19) | −0·08 (−1·70, 0·05) |
| Temperature, median (Q1, Q3), °C | 37·7 (37·1, 38·6) | 38·5 (37·8, 39·2) | 38·3 (37·3, 39·2) | 37·8 (37·0, 38·6) | 38·5 (37·7, 39·5) | 38·6 (37·9, 39·5) |
| Respirations, median (Q1, Q3), min −1 | 34 (28, 44) | 38 (36, 44) | 36 (30, 46) | 42 (36, 54) | 40 (32, 48) | 42 (36, 52) |
| Respiratory Distress † , N (%) | 692 (20) | 473 (9) | 1,563 (23) | 1,631 (24) | 99 (6) | 212 (12·5) |
| Haemoglobin, median (Q1, Q3), g/L | 63 (45, 86) | 88 (68, 103) | 80 (61, 96) | 62 (47, 85) | 77 (58, 95) | 62 (46, 84) |
| Severe anaemia ‡ , N (%) | 640 (19) | 282 (5) | 489 (7) | 999 (14) | 131 (7) | 262 (15·4) |
| Glucose, median (Q1, Q3), mmol/L | 6·4 (4·8, 8·0) | 5·3 (4·4, 6·2) | 5·2 (4·2, 6·3) | 5·1 (4·2, 6·1) | 4·1 (3·1, 5·1) | 5·3 (4·3, 6·4) |
| Hypoglycemia § , N (%) | 126 (6) | 134 (3) | 322 (5) | 295 (4) | 164 (10) | 53 (3) |
| Parasitaemia, median (Q1, Q3), ul−1 ** | 19,500 (1,500–78,000) | 83,778 (33,333–189,111) | 39,330 (3,140–215,800) | 65,877 (14,281–241,152) | 51,000 (9,000–200,000) | 71,500 (15,500–220,000) |
| Blantyre Coma Score, N (%) | ||||||
| 5 | 2,587 (76) | 4,809 (90) | 5,539 (80) | 5,289(76) | 1,587 (89) | 1,128 (67) |
| 4 | 248 (7) | 113 (2) | 468 (7) | 464 (7) | 55 (3) | 219 (13) |
| 3 | 275 (8) | 147 (3) | 187 (3) | 350 (5) | 56 (3) | 155 (9) |
| 2 | 184 (5) | 128 (2) | 364 (5) | 422 (6) | 64 (4) | 127 (8) |
| 1 | 70 (2) | 85 (2) | 172 (3) | 238 (3) | 27 (2) | 51 (3) |
| 0 | 31 (1) | 81 (2) | 179 (3) | 178 (3) | 1 (0·1) | 16 (1) |
| Impaired consciousness ‖ , N (%) | 808 (24) | 554 (10) | 1,370 (20) | 1,652 (24) | 203 (11) | 568 (33) |
| Lactate, median (Q1, Q3), mmol/L | 3·9 (2·4,7·0) | 3·6 (2·2,6·0) | 2·3 (1·6,3·5) | 3·2 (2·1,5·2) | 3·8 (2·4,5·3) | 3·8 (2·4,5·8) |
| Lactate, N (%) | ||||||
| < 3·0 mmol/L | 990 (35) | 2,108 (40) | 4,517 (67) | 3,104 (45) | 495 (35) | 503 (35) |
| 3·0 – 4·9 mmol/L | 768 (27) | 1,400 (27) | 1,351 (20) | 1,954 (28) | 520 (37) | 469 (33) |
| ≥ 5·0 mmol/L | 1,106 (39) | 1,737 (33) | 866 (13) | 1,886 (27) | 408 (29) | 453 (32) |
| Transfused ¶ , N (%) | 1,526 (46) | 813 (15) | 1,029 (15) | 3,934 (57) | 382 (21) | 829 (50) |
| Outcome | ||||||
| Survived, N | 3,012 | 5,148 | 6,640 | 6,596 | 1,759 | 1,599 |
| Died, N (%) | 316 (7) | 133 (3) | 232 (3) | 313 (5) | 24 (1) | 83 (5) |
| Absconded, N | 24 | 82 | 30 | 35 | 9 | 18 |
Variables were compared across sites using Kruskal-Wallis test for continuous variables, and chi-squared for categorical variables. All variables differed significantly between sites (P< 0·0001), except sex (P = 0·12).
Respiratory distress: presence of deep breathing, irregular breathing, or chest indrawing.
Severe anemia: hemoglobin less than or equal to 40 g/L.
Hypoglycaemia: blood glucose less than 2·2 mmol/L
Impaired consciousness: Blantyre Coma Score less than or equal to 4.
Baseline data separated by transfusion status is available in Table S1.
In Blantyre and Kumasi, parasite density was counted per 200 WBCs and an assumption of 8,000 WBC per microliter was applied. In Kilifi, the parasite count was calculated by multiplying the parasite count per 100 WBC times the WCC determined by Coulter counter (Coulter MDII). At all other sites, parasite density was based on reading 100 high-powered fields. Complete blood counts were not available. This approach may have introduced variability in the estimation of parasite density that may have varied by site.
The percentage of missing values for each variable were as follows: age (0%), sex (0%), weight (0%), temperature (0·2%), respirations (0·4%), respiratory distress (0·1%), haemoglobin (0·3%), severe anaemia (0·3%), glucose (5·9%), hypoglycaemia (5·9%), parasitaemia (0%), Blantyre coma score (0·1%), Impaired consciousness (0·1%), lactate (5·6%), transfused (0·8%), outcome (0·2%).