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Table 1 Malaria-related complications

From: Clinical and epidemiological aspects of complicated malaria in Colombia, 2007–2013

Criteria Defined before 2010 [22] Defined after 2010 [21]a
Cerebral malaria Impaired consciousness or coma (Blantyre score < 3 or Glasgow score < 9); unconsciousness with the possibility of waking up Unchanged
Renal dysfunction Serum creatinine > 3.0 mg/dL and/or urine vol < 400 mL in 24 h (adults) or <12 mL/kg of body weight in 24 h (children) Serum creatinine > 1.5 mg/dL
Hepatic dysfunction Serum bilirubin > 3 mg/dL and altered liver function tests Serum bilirubin > 1.5 mg/dL or aminotransferases > 40 U/L
Respiratory distress Increased respiratory rate at admission, presence of abnormal lung sounds or pulmonary oedema (X-rays) Unchanged
Circulatory collapse or shock SBP < 70 mm Hg in adults or <50 mm Hg in children (3–5 years) SBP < 80 mm Hg in adults
Hyperemesis >5 episodes in 24 h Not applicableb
Hyperpyrexia Axillary temperature >39.5 °C Not applicableb
Hypoglycaemia Blood glucose level < 40 mg/dL. Blood glucose level < 60 mg/dL
Severe anaemia Haemoglobin < 5 g/dL or haematocrit < 15 % Haemoglobin < 7 g/dL
DIC Abnormal bleeding in the presence of laboratory evidence of DIC Unchanged
Acidaemia/acidosis and hyperlactemia Acidaemia/acidosis (clinical signs) Plasmatic bicarbonate < 15 mmol/L or base excess > −10; acidaemia pH <7.35; lactate acid > 5 mmol/L
Haemoglobinuria Macroscopic haemoglobinuria Macroscopic haemoglobinuria and positive urine dipstick
Hyperparasitaemia >100,000 asexual parasites/μL of P. falciparum or in mixed infection with P. vivax and schizontaemia >50,000 asexual parasites/μL
  1. DIC disseminated intravascular coagulation, SBP systolic blood pressure
  2. aIncludes only the changes based on previous evidence
  3. bCurrently classified as a warning sign for complicated malaria development