TABLE 2.
Clinical and laboratory characteristics on admission in children with severe malaria, according to intestinal injurya
| Parameter | Value for: |
P value | |||
|---|---|---|---|---|---|
| No. (% missing) | Combined (n = 598) | Intestinal injury (n = 108) | No intestinal injury (n = 490) | ||
| Demographic characteristics | |||||
| Age, in yrs | 598 (0) | 2.1 (0.92) | 2.1 (0.86) | 2.1 (0.93) | 0.36 |
| Sex, no. (%) female | 598 (0) | 261 (43.7) | 52 (48.2) | 209 (42.7) | 0.30 |
| Wt-for-age z score | 591 (1.2) | −1.1 (1.1) | −1.4 (1.1) | −1.0 (1.1) | 0.001 |
| Ht-for-age z score | 598 (0) | −1.1 (1.3) | −1.3 (1.2) | −1.1 (1.3) | 0.03 |
| Wt-for-ht z score | 591 (1.2) | −0.68 (1.1) | −0.94 (1.3) | −0.62 (1.1) | 0.01 |
| Admission characteristics | |||||
| Symptoms | |||||
| History of fever, days | 587 (1.8) | 3.6 (2.3) | 3.7 (2.3) | 3.6 (2.3) | 0.80 |
| Diarrhea, no. (%) | 598 (0) | 115 (19.2) | 31 (38.7) | 84 (17.1) | 0.01 |
| Vomiting, no. (%) | 598 (0) | 316 (52.8) | 67 (62.0) | 249 (50.8) | 0.03 |
| Convulsions, no. (%) | 598 (0) | 301 (50.3) | 43 (39.8) | 258 (52.7) | 0.02 |
| Clinical signs | |||||
| Temp, °C | 598 (0) | 37.7 (1.2) | 37.3 (1.3) | 37.8 (1.2) | <0.001 |
| Pulse, beats/min | 598 (0) | 158 (23) | 153 (25) | 159 (23) | 0.02 |
| Tachycardia, no. (%) | 598 (0) | 442 (73.9) | 72 (66.7) | 370 (75.5) | 0.06 |
| Respiratory rate, breaths/min | 598 (0) | 51 (13) | 54 (14) | 50 (13) | 0.002 |
| Tachypnea, no. (%) | 596 (0.33) | 596 (99.7) | 108 (100) | 488 (99.6) | 1.00 |
| Systolic blood pressure, mm Hg | 589 (1.5) | 98 (13) | 96 (13) | 98 (13) | 0.14 |
| Blantyre coma score, no. (%) | |||||
| 0 | 597 (0.17) | 9 (1.5) | 4 (3.7) | 5 (1.0) | 0.005 |
| 1 | 27 (4.5) | 9 (8.3) | 18 (3.7) | ||
| 2 | 57 (9.6) | 14 (13.0) | 43 (8.8) | ||
| 3 | 62 (10.4) | 14 (13.0) | 48 (9.8) | ||
| 4 | 50 (8.4) | 12 (11.1) | 38 (7.8) | ||
| 5 | 392 (65.7) | 55 (51.0) | 337 (68.9) | ||
| Shock, no. (%) | 588 (1.7) | 49 (8.3) | 17 (16.2) | 32 (6.6) | 0.001 |
| Temp gradient, no. (%) | 596 (0.33) | 34 (5.7) | 12 (11.2) | 22 (4.5) | 0.01 |
| Dehydration, no. (%) | 598 (0) | 70 (11.7) | 25 (23.2) | 45 (9.2) | <0.001 |
| Jaundice, no. (%) | 597 (0.17) | 137 (23.0) | 41 (38.3) | 96 (19.6) | <0.001 |
| Laboratory findings (median, IQR) | |||||
| Hemoglobin, g/dL | 595 (0.50) | 5.7 (3.6–8.6) | 4.2 (2.8–6.7) | 6.1 (4.0–8.9) | <0.001 |
| Glucose, mmol/L | 594 (0.67) | 6.9 (5.5–8.5) | 7.1 (4.5–8.9) | 6.9 (5.6–8.5) | 0.46 |
| Lactate, mmol/L | 573 (4.2) | 4.2 (2.4–7.6) | 5.9 (2.9–13.2) | 4.0 (2.3–6.7) | <0.001 |
| WBCs, ×103/μL | 595 (0.50) | 12.1 (8.7–19.2) | 20.0 (12.2–32.7) | 11.1 (8.3–17.3) | <0.001 |
| Platelets, ×103/μL | 595 (0.50) | 113 (62–216) | 147 (81–270) | 104 (58–212) | 0.01 |
| Peripheral parasite density, parasites/μL | 598 (0) | 13,434 (0–135,627) | 2,928 (0–54,121) | 19,645 (49–158,019) | 0.001 |
| Plasma HRP-2, ng/mL | 593 (0.84) | 2,372 (364–5,898) | 1,929 (204–4,763) | 2,407 (433–6,220) | 0.42 |
| Comorbid diagnoses | |||||
| Blood culture positive, no. (%) | 584 (2.3) | 22 (3.8) | 4 (3.7) | 18 (3.8) | 1.00 |
| Gram negative, no. (%) | 22 | 15 (68.2) | 2 (50) | 13 (72.2) | 0.57 |
| Gram positive, no. (%) | 22 | 7 (31.8) | 2 (50) | 5 (27.8) | 0.57 |
| Stool helminth, no. (%) | 480 (19.7) | 17 (3.5) | 3 (4.1) | 14 (3.4) | 0.73 |
| Gastroenteritis, no. (%) | 598 (0) | 88 (14.8) | 26 (24.1) | 62 (12.7) | 0.004 |
| HIV, no. (%) | 594 (0.67) | 13 (2.2) | 2 (1.9) | 11 (2.3) | 1.00 |
| Medication history | |||||
| Prior antibiotics, no. (%) | 588 (1.7) | 203 (34.5) | 47 (43.9) | 156 (32.4) | 0.02 |
| Prior antimalarial, no. (%) | 588 (1.7) | 364 (61.9) | 66 (61.7) | 298 (62.0) | 0.96 |
a
Data are presented are means (SD) unless otherwise indicated. Intestinal injury versus no intestinal injury compared using Student’s t test for Gaussian continuous measures or Wilcoxon rank sum test for non-Gaussian continuous measures (i.e., laboratory findings), and chi-square test or Fisher’s exact test, as appropriate, for categorical measures.