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Table 2 Clinical studies using severe thrombocytopaenia as a criterion of severe malaria

From: Imported Plasmodium vivax malaria with severe thrombocytopaenia: can it be severe malaria or not?

References Type of study/country No patients with severe P.vivax malaria/P. vivax malaria (%) Exclusion P. falciparum a/Exclusion of other infectious diseases No patients with severe thrombocytopaenia among those with severe malaria (%) No patients with bleeding manifestation (tipology) Death
[13] Prospective (adults)/India 40/456 (0.08) Yes (RDT)/PCR/Yes 5 (12.5) 2 (Severe epistaxis requiring blood and platelet transfusions) 2 due to ARDS (none with Thp)
[14] Prospective (pediatrics)/India 24/35 (68.6) No/No 17 (70.8)b 2 (Epistaxis) None
[52] Retrospective (adults and pediatrics)/India 17/221 (7.7) No/No 13 NR 3 (Pregnant women with ARDS)
[53] Retrospective (adults)/India 28/30 (93.3) No/No 28 (93.3) None 2:1 ARDS, 1 CM (none with Thp)
[54] Retrospective (pediatrics)/India 23/108 (21.3) Yes (RDT)/No 9/23 (39.1) 3 (Petechiae, purpura) 1: GI bleeding, DIC, renal failure
[55] Retrospective (adults)/India 43/121 (35.5) Yes (RDT)c/No 43 None 3 due to ARDS (none with Thp)
[56] Prospective (pediatrics)/India 60/380 (15.8) Yes (RDT)/Yes 51/60 (85) 44 (Epistaxis); 19 (hematemesis) None
[57] Retrospective (adults)/India 107/213 (50.2) Yes (RDT)/No 17 (15.8) None None
[58] Retrospective (pediatrics)/India 45/131 (21.1) Yes (RDT)/No 17 (13) 12 (NR) 4:2 ARDS/ARF; 1 CM; 1 DIC
[59] Retrospective (pediatrics)/India 54/261 (20.7) Yes (RDT)/Yes 20 (37) 10 (NR) None
[60] Prospective (adults and pediatrics)/India 200/900 (22.2) Yes (RDT)/No 24/200 (12) 4 (Purpuric eruptions) 40
[61] Prospective (adults)/India 22/198 (11.1) Yes (RDT + PCR)/No 7/14 (50)d 9 (NR) 2 CM and ARDS (none with Thp)
[62] Prospective (pediatrics)/India 38/61 (62.3) Yes (RDT)/No 18/38 (47.4) NR 5 (3 ARDS)
[63] Prospective (pediatrics)/Pakistan 397,128 (30.5) No/No 15 (38.5) NR 1 with GCS <10, convulsion (without Thp)
[64] Retrospective (adults)/India 111/296 (37.5) Yes (RDT + PCR)e/No 58/111 (52.2) 16 (GI, genitourinary or respiratory tracts) 3 8 acute myocardial infarction)
[65] Retrospective (adults and pediatrics)/India 83/359 (23.1) No/No 13 (15.7) 4 (NR) None
[66] Prospective (pediatrics)/Sudan 18/18 (100) No/No 4 (22.2) 2 epistaxis None
Total   952/3916 (24.3) 11/17 (64.7)/3/17 (17.6) 359/952 (37.7) 106/3506 (3)/106/310 (34.2) 66/952 (6.9)
  1. aBy polymerase chain reaction (PCR) or rapid diagnostic tests (RDTs)
  2. bAll patients with less than 150.000 per μL were considered
  3. cOnly some patients underwent RDT analysis
  4. dIn this study severe thrombocytopaenia was considered with value <80.000 per μL
  5. eOnly discordant samples
  6. RDT rapid diagnostic test, PCR polymerase chain reaction, NR not reported, Thp thrombocytopaenia, CM cerebral malaria, ARDS acute respiratory distress syndrome