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Table 3 Chronic conditions associated with severe imported falciparum malaria in the study population

From: Hypertension is associated with an increased risk for severe imported falciparum malaria: a tertiary care hospital based observational study from Berlin, Germany

Chronic co-morbidity

No. (%) of patients

P valuea

OR (95% CI)

Total (n = 536)

Non severe malaria (n = 468)

Severe malaria (n = 68)

Unadjustedb

Adjustedc

No. of co-morbidities

 0

441 (82.3)

394 (84.2)

47 (69.1)

< 0.002

1 (Ref)

 

 1

61 (11.4)

50 (10.7)

11 (16.2)

0.183

1.844 (0.898–3.787)

 

 2

29 (5.4)

20 (4.3)

9 (13.2)

0.002

3.772 (1.624–8.765)

 

 3

5 (0.9)

4 (0.9)

1 (1.5)

0.625

2.096 (0.229–19.15)

 

Seriousness of underlying disorders (CA-CCI)

≥ 2

110 (20.5)

85 (18.2)

25 (36.8)

< 0.001

2.83 (1.644–4.871)

 

Nutritional status

 BMI, median (range)

24.5 (18.0–39.2)

24.6 (18.0–39.2)

24.4 (18.0–34.9)

0.388

  

 Obesityd

24 (9.8)

19 (9.9)

5 (9.4)

0.920

1.054 (0.374–2.970)

 

Individual diseases

 Cardiovascular disease

12 (2.2)

5 (1.1)

7 (10.3)

< 0.001

8.961 (2.656–30.234)

8.197 (2.300–29.216)

 Hypertension

43 (9.2)

30 (6.4)

13 (19.1)

< 0.001

4.447 (2.233 -8.857)

3.061 (1.335–7.021)

 Pulmonary disease

13 (2.4)

12 (2.6)

1 (1.5)

0.567

1.763 (0.226–13.779)

 

 History of or active smoking

31 (5.8)

24 (5.1)

7 (10.3)

0.088

2.123 (0.878–5.136)

 

 Endocrine/metabolic disordere

31 (5.8)

26 (5.6)

5 (7.4)

0.553

1.715 (0.677–4.345)

 

 Diabetes mellitus

16 (3.0)

14 (3.0)

2 (2.9)

0.982

1.615 (0.448–5.822)

 

 Dyslipidaemia

6 (1.1)

3 (0.6)

3 (4.4)

0.006

7.154 (1.414–36.193)

6.082 (1.125–32.876)

 Metabolic syndromef

5 (0.9)

3 (0.6)

2 (2.9)

0.065

4.697 (0.770–28.634)

 

 Chronic infectious diseaseg

31 (5.8)

23 (4.9)

8 (11.8)

0.024

2.123 (0.878–5.136)

 

 HIV infection

15 (2.8)

10 (2.1)

5 (7.4)

0.015

2.597 (0.803–8.399)

 

 Chronic hepatitis

12 (2.2)

9 (1.9)

3 (4.4)

0.195

1.94 (0.51–7.33)

 

 Malignancy

9 (1.7)

6 (1.3)

3 (4.4)

0.042

3.554 (0.868–14.557)

 

 Chronic renal disease

10 (1.9)

9 (1.9)

1 (1.5)

0.797

1.314 (0.164–10.535)

 

 Alcoholism

4 (0.7)

1 (0.2)

3 (4.4)

< 0.001

21.554 (2.209–210.303)

19.217 (1.848–199.870)

 Gastrointestinal disorder

4 (0.7)

3 (0.6)

1 (1.5)

0.458

2.313 (0.237–22.564)

 

 Autoimmune/rheumatoloic disorder

4 (0.7)

3 (0.6)

1 (1.5)

0.458

2.313 (0.237–22.564)

 

 Neurologic disorder

2 (0.4)

2 (0.4)

 
  1. CA-CCI age-adjusted Charleson co-morbidity index, CI confidence interval, HIV human immunodeficiency virus, OR odds ratio
  2. aEstimated by Chi square test
  3. bOdds ratios (OR) determined by univariate logistic regression
  4. cAdjusted odds ratios (OR) were determined in separate multivariable models including the individual diagnoses together with age (continuous), origin from endemic region, and lack of previous malaria episodes as potential confounders
  5. dObesity: BMI ≥ 30 kg/m2. A BMI was available for 245 cases, 192 with non-severe and 53 with severe malaria
  6. eEndocrine/metabolic disorded included diabetes, dyslipidaemia, hypo- and hyperthyroidism, and hyperuricaemia/gout
  7. fMetabolic syndrome: obesity together with at least one of the following: hypertension, diabetes, or dyslipidaemia
  8. gChronic infectious disease included infections with HIV, hepatitis B and C, Strongyloides stercoralis, and filarial parasites