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Table 1 Criteria used as indicators of severe malaria in the study

From: The clinical spectrum of severe childhood malaria in Eastern Uganda

Clinical criteria

Definition

Clinical jaundice

Yellow mucous membranes noted in sufficient daylight

Respiratory distress

Increased work of breathing, manifesting as deep, fast or very slow breathing, including retractions and the use of accessory muscles

Severe anaemia

Haemoglobin < 5 g/dL

Prostration

Generalized weakness so that the patient is unable walk or sit up without assistance

Coma

Unrousable state with a corresponding Blantyre Coma Score (BCS) of ≤ 2 for which no other cause other than malaria could be identified

Haemoglobinuria

History of or clinician-observed red or cola-coloured urine

Multiple convulsions

More than two grand-mal seizures during the 24-h period preceding admission

Spontaneous bleeding

Physically un-induced and irrepressible bleeding from at least 2 non-traumatized sites in a patient with severe malaria without previous history of abnormal bleeding

Laboratory criteria

 Hyperlactataemia

Lactate > 5 mmol/L

 Hyperparasitaemia

>5% parasitized erythrocytes or > 250 000 parasites/μL

 Hyperpyrexia

Axillary temperature ≥ 40.0°C

 Hypoxaemia

Oxygen saturation < 90%

 Hypoglycaemia

Whole blood glucose concentration < 2.2 mmol/L

 Metabolic acidosis

Plasma bicarbonate < 15 mmol/L