Table 1 Definitions used in this study*

Cerebral malaria

Altered state of consciousness (irreversible coma), unconsciousness with the possibility of waking up, prostration, extreme weakness (patient cannot sit or stand), generalized convulsions or behavioral disturbance.

Renal complication

Serum creatinine > 3.0 mg/dl and/or urine vol < 400 ml in 24 hours (adults) or <12 ml/kg of body weight in 24 hours (children)

Lung or respiratory distress syndrome

Increased respiratory rate at admission, presence of abnormal lung sounds, such as wheezing, rhonchi, rales, and radiographic changes consistent with pulmonary oedema.

Shock

Systolic blood pressure <70 mm Hg in adults or <50 mm Hg in children.

Hypoglycaemia

Glucose < 40 mg/dl.

Hyperemesis

Uncontrollable and frequent vomiting, >5 times in 24 hours, which prevents anti-malarial treatment orally.

Hyperpyrexia

Axillary temperature >39.5°C

Severe anemia

Haematocrit < 15% or Hb <5 g/dl, Spontaneous bleeding or disseminated intravascular coagulation (DIC), acidaemia/acidosis (clinical signs), macroscopic haemoglobinuria

Complicated malaria case

Any patient with probable case of malaria complicated by the presence of asexual (trophozoites/schizonts) of P. falciparum confirmed by parasitological examination and who has been ruled out another etiology, or any patient with confirmed cases of malaria with >50,000 parasite asexual forms /μL (hyperparasitaemia)

Death from malaria

Patient with signs and symptoms of complicated malaria, with confirmed diagnose of P. falciparum (or P. vivax) or associated infection.

Complication hepatic jaundice

Total serum bilirubin >3 mg/dl and altered liver function tests.