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Table 1 Patterns of symptoms, clinical signs and laboratory biomarkers found in malaria conditions in the literature and the EMBLEM Study

From: Endemic Burkitt lymphoma: a complication of asymptomatic malaria in sub-Saharan Africa based on published literature and primary data from Uganda, Tanzania, and Kenya

Type of malaria

Severe malaria

Uncomplicated malaria

Severe malaria

Uncomplicated malaria

Non-EMBLEM data

EMBLEM data

Malaria conditionsa

Anaemia

Hyperparasitaemia

Moderate malaria

Prostration

Cerebral

Mild malaria

Burkitt lymphoma

Asymptomatic controls

Burkitt lymphoma

(n = 850)

Healthy controls (n = 2878)

Demographics

–

–

–

–

–

–

–

–

–

–

 Age, years (mean + SD)

1.73 (1.73)

1.88 (1.94)

2.21 (1.25)

2.29(2.27)

2.64 (2.59)

3.22 (3.78)

7.1 (2.9)

9.8 (2.2)

7.16 (3.57)

7.39 (3.32)

 0–2

76.8%

52.0%

73.5%

65.5%

55.4%

48.0%

2.4%

0.1%

10.1%

6.7%

 3–5

22.5%

46.3%

26.4%

29.0%

34.8%

28.7%

30.6%

4.07%

34.8%

35.4%

 6–8

0.7%

1.7%

0.1%

5.3%

9.1%

16.8%

38.6%

31.5%

24.9%

29.6%

 9–11

0.00%

< 0.01%

0.01%

0.2%

0.7%

6.4%

18.0%

48.5%

16.7%

14.6%

 12–15

0.00%

0.00%

< 0.01%

0.0%

0.0%

0.0%

10.4%

15.9%

13.4%

13.7%

Gender

–

–

–

–

–

–

–

–

–

–

Male

52.9%

51.4%

56.5%

52.5%

48.3%

51.7%

63.2%

47.8%

61.7%

53.4%

Female

47.1%

48.6%

43.5%

47.5%

51.7%

48.3%

36.8%

52.2%

38.3%

46.6%

Male:Female Ratio

1.12:1

1.06:1

1.30:1

1.11:1

0.93:1

1.07:1

1.71:1

1.15:1

1.61:1

1.15:1

Mortality

 % deaths from condition

2.7%

7.20%

5.00%

6.70%

26.70%

< 1%

15.69%

< 1%a

–

–

Malaria symptoms

 Multiple Seizures

4.7%

26.0%

1.99%

60.00%

78.00%

0.00%

–

0.00%

–

–

 Headaches

–

–

88.00%

0.00%

12.00%

–

–

0.00%

30.52%

4.34%

 Weakness/Lethargy

–

27.4%

14.00%

100.00%

12.40%

–

–

0.00%

66.18%

1.50%

 Diarrhoea

40.6%

–

43.00%

–

6.10%

35.00%

–

0.00%

1.72%

0.53%

 Myalgia

–

–

11.00%

0.00%

0.00%

–

–

0.00%

20.34%

0.04%

 Nausea/vomiting

64.1%

–

58.00%

–

36.90%

39.00%

–

0.00%

17.28%

1.64%

Malaria signs

 Fever (> 37.5 °C)

–

–

–

–

–

–

–

–

–

–

 Temperature (mean + SD)

37.3 (1.5)°C

37.9 (1.6)°C

37.5 (2.16)°C

38.0 (1.4)°C

37.94 (1.41) °C

37.7 (2.75)°C

–

36.3 (–)°C

–

–

 % fever, last 6 months

56.5%

60.6%

51.00%

64.00%

62.30%

56.52%

–

0.00%

62.01%

70.93%

 Dry cough

33.0%

–

36.00%

–

39.55%

26.00%

–

0.00%

26.23%

12.88%

 Coma

0% (5)

0% (5)

0% (≥ 4)

0% (≤ 3)

98% (≤ 2)

0% (5)

–

0% (5)

0% (5)

0% (5)

 Hepatosplenomegaly

68.0%

63.0%

13.00%

22.90%

55.00%

< 1%

–

0.00%

59.80%

0.24%

 Jaundice

83.3%

24.0%

1.49%

28.60%

86.70%

4.10%

–

0.00%

11.64%

0.63%

 Pallor

37.5%

24.0%

42.00%

–

34.55%

4.00%

–

0.00%

–

–

 Respiratory distress

61.0%

71.0%

7.67%

100.00%

72.00%

7.00%

–

0.00%

33.09%

0.67%

Haemoglobin (HB), g/dL

 Hb (mean + SD)

3.8 (1.3)

4.9 (3.1)

7.8(2.38)

10.0 (3.3)

6.76 (3.24)

11.5 (0.8)

10.35 (3.24)

11.7(1)

10.05 (2.30)

12.26 (1.56)

Anaemia

 Any (< 11 g/dL)

100.0%

97.4%

91.01%

61.80%

90.40%

26.19%

57.80%

23.88%

63.42%

17.84%

 Mild (8.0–10.9 g/dL)

0.06%

13.7%

37.83%

34.67%

25.62%

26.19%

34.47%

23.87%

43.97%

16.47%

 Moderate (5.1–7.9 g/dL)

17.6%

32.6%

41.23%

20.64%

35.40%

0.00%

18.38%

0.01%

18.49%

1.29%

 Severe (< 5 g/dL)

82.3%

51.1%

11.95%

6.49%

29.38%

0.00%

4.95%

0.00%

0.96%

0.08%

Platelet count

 Platelets (mean + SD) × 103)

126.0 (109.0)

88.1 (85.3)

159.0(143.8)

100.7 (127.9)

82.5 (94.1)

247(168)

347.7 (220.6)

244.2 (135.3)

353.4 (184.3)

306.5 (117.7)

 Normal (150,000–300,000 Platelets/µL)

41.3%

23.4%

52.40%

35.00%

23.65%

71.82%

81.50%

74.94%

88.24%

94.83%

 Low (< 150,000 Platelets/µL)

58.7%

76.6%

47.60%

65.00%

76.35%

28.18%

18.50%

25.06%

11.76%

5.17%

White blood cell (WBC)

 WBC (Mean + SD) (× 103)

13.3 (11.1)

12.3 (10.1)

10.3 (5.19)

8.3 (5.5)

10.31 (7.79)

13.5 (8.1)

8.18 (4.12)

7.1 (4.33)

8.89 (6.96)

7.41 (3.29)

 High (> 10,000 cells/µL)

66.0%

62.0%

52.3%

38.1%

46.0%

66.7%

33.4%

25.1%

26.6%

12.9%

 Normal (< 10,000 cells/µL)

34.0%

38.0%

47.7%

61.9%

54.0%

33.3%

66.6%

74.9%

73.4%

87.0%

Malaria parasite tests

 Malaria RDT,  %

–

–

–

–

–

 

46%

38.43%

25.98%

43.81%

Parasite density (parasites/µL)

 Mean density + SD) × 103)

49.4 (99.4)

869.3 (1166.2)

30.34(47.06)

44.6 (74.4)

38.9 (103.8)

13.905 (38.49)

 

1.827 (4.610)

2.81 (13.47)

7.78 (34.61)

 Density < 250,000/uL)

97.8%

0.0%

100.0%

99.7%

97.9%

100.0%

 

100.0%

100.0%

99.6%

 Density > 250,000/uL)

2.18%

100.0%

0.0%

0.29%

2.10%

0.00%

 

0.0%

0.0%

0.39%

  1. aMalaria conditions are sorted in ascending order according to the age of diagnosis; Numbers are not included for non-EMBLEM subjects because these data were compiled from different papers (details in Additional file 1: Table S1)