Table 4 Criteria for diagnosis of co-morbidities to be excluded from the primary case definition of severe malaria
Criteria for co-morbidity | Definition |
|---|---|
Radiographically proven pneumonia | • Consolidation or pleural effusion on a chest X-ray taken within 72 h of admission |
Meningitis on cerebrospinal fluid examination | • White cells ≥50 × 106/L or positive culture of compatible organism or latex agglutination antigen detection test positive for Hib, pneumococci or meningococci |
Sepsis (positive blood culture) | • Blood culture taken within 72 h of admission is considered positive if: |
|  |    - A definite pathogen is isolated (e.g. Streptococcus pneumoniae, S agalactiae, S pyogenes, Haemophilus influenzae, Salmonella spp.) |
|  |    - A bacteria that could be either a pathogen or a contaminant is isolated within 48 h of incubation (e.g. Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus faecalis) |
Gastroenteritis with dehydration | • A history of 3 or more loose or watery stools in previous 24 h and an observed watery stool with decreased skin turgor (>2 seconds for skin to return following skin pinch) |