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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