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Table 1 Criteria used to define severe malaria cases according to national guidelines

From: A descriptive study of 16 severe Plasmodium vivax cases from three municipalities of Colombia between 2009 and 2013

Clinical criteria* Laboratory criteria*
1. Loss of consciousness or profound coma 1. Haemoglobinuria
2. Prostration; extreme weakness with inability to walk or sit without assistance 2. Hypoglycaemia (<60 mg/dl)
3. Inability to feed oneself 3. Metabolic acidosis (plasmatic bicarbonate <15 mmol/L)
4. Multiple seizures; more than 1 episode in 24 hours 4. Hyperlactaemia (lactate acid <5 mmol/L)
5. Respiratory distress syndrome 5. Severe anaemia (haemoglobin <7 g/dL, haematocrit <21%)
6. Circulatory collapse/shock; systolic arterial pressure <80 mmHg in adults and <50 mmHg in children 6. Hyperparasitaemia (>50,000 asexual parasites/uL) with the diagnosis of P. falciparum, or mixed infection with P. vivax
7. Clinical jaundice with signs of vital organ failure 7. Thrombocytopaenia (<50,000 mm3)
8. Spontaneous haemorrhage 8. Elevated transaminase (>80 IU)
9. Pulmonary oedema evidenced through radiography 9. Elevated total bilirubin (>1.5 mg/dL)
  10. Renal insufficiency (serum creatinine level >1.5 mg/dL)
  1. *Ministry of Social Protection. Republic of Colombia. Public Health General Management. National Institute of Health. World Health Organization: Guideline for the integral clinical treatment of patients with Malaria. Bogotá; 2010 [41].