Table 1 Severity criteria in Plasmodium falciparum malaria

Clinical

Impaired consciousness

Any impairment in consciousness, not related to other causes (hypoglycaemia, concomitant infection)

Prostration

Generalized weakness so that the patient is unable to sit, stand or walk without assistance

Multiple convulsions

More than two episodes within 24 h

Respiratory failure

PaO₂ <60 mmH (FiO2 21 %)

Shock

Systolic blood pressure <80 mmHg

Jaundice

Clinical jaundice plus evidence of other vital organ dysfunction

Bleeding

Spontaneous bleeding without any other potential cause

Analytical and radiological

Hypoglycaemia

<2.2 mmol/l or <40 mg/dl

Metabolic acidosis

Plasma bicarbonate <15 mmol/l

Severe normocytic anaemia

Haemoglobin <5 g/dl

Haemoglobinuria

Haemoglobin in urine

Hyperlactataemia

Lactate >5 mmol/l

Renal impairment

Serum creatinine >265 µmol/l

Pulmonary oedema or distress respiratory syndrome

Bilateral alveolar infiltrates in chest x-ray

Parasitological

Hyperparasitaemia

Parasitaemia >2.5 %