| Selidji T. Agnandji, Mario Recker, Benjamin Mordmüller, Stephan Glöckner, Akim A. Adegnika, Bertrand Lell, Lucas Otieno, Walter Otieno, Seth Owusu-Agyei, Kwaku P. Asante, Tsiri Agbenyega, Daniel Ansong, Eusebio Macete, Pedro Aide, Hermann Sorgho, Halidou Tinto, Neema Mturi, John P. A. Lusingu, Samwel Gesase, Irving Hoffman, Nahya Salim Masoud, Charles R. Newton, Kalifa Bojang, Gérard Krause, Peter Gottfried Kremsner Prostration and the prognosis of death in African children with severe malaria Journal Article In: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, vol. 134, pp. 240-247, 2023, ISSN: 1878-3511. @article{Agnandji2023,
title = {Prostration and the prognosis of death in African children with severe malaria},
author = {Selidji T. Agnandji and Mario Recker and Benjamin Mordm\"{u}ller and Stephan Gl\"{o}ckner and Akim A. Adegnika and Bertrand Lell and Lucas Otieno and Walter Otieno and Seth Owusu-Agyei and Kwaku P. Asante and Tsiri Agbenyega and Daniel Ansong and Eusebio Macete and Pedro Aide and Hermann Sorgho and Halidou Tinto and Neema Mturi and John P. A. Lusingu and Samwel Gesase and Irving Hoffman and Nahya Salim Masoud and Charles R. Newton and Kalifa Bojang and G\'{e}rard Krause and Peter Gottfried Kremsner},
url = {https://pubmed.ncbi.nlm.nih.gov/37414210/},
doi = {10.1016/J.IJID.2023.06.022},
issn = {1878-3511},
year = {2023},
date = {2023-01-01},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {134},
pages = {240-247},
publisher = {Int J Infect Dis},
abstract = {Objectives: Malaria is still one of the main reasons for hospitalization in children living in sub-Saharan Africa. Rapid risk stratification at admission is essential for optimal medical care and improved prognosis. Whereas coma, deep breathing, and, to a lesser degree, severe anemia are established predictors of malaria-related death, the value of assessing prostration for risk stratification is less certain. Methods: Here we used a retrospective multi-center analysis comprising over 33,000 hospitalized children from four large studies, including two observational studies from the Severe Malaria in African Children network, a randomized controlled treatment study, and the phase-3-clinical RTS,S-malaria vaccine trial, to evaluate known risk factors of mortality and with a specific emphasis on the role of prostration. Results: Despite comparable age profiles of the participants, we found significant inter- and intra-study variation in the incidence of fatal malaria as well as in the derived risk ratios associated with the four risk factors: coma, deep breathing, anemia, and prostration. Despite pronounced variations, prostration was significantly associated with an increased risk of mortality (P \<0.001) and its consideration resulted in improved predictive performance, both in a multivariate model and a univariate model based on the Lambar\'{e}n\'{e} Organ Dysfunction Score. Conclusion: Prostration is an important clinical criterion to determine severe pediatric malaria with possible fatal outcomes.},
keywords = {Anemia*, Child, Clinical Trial, Coma, doi:10.1016/j.ijid.2023.06.022, Falciparum* / drug therapy, Humans, Infant, Malaria, Malaria* / complications, Malaria* / diagnosis, Mario Recker, MEDLINE, Multicenter Study, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Peter Gottfried Kremsner, Phase III, pmid:37414210, Prognosis, PubMed Abstract, Randomized controlled trial, Selidji T Agnandji},
pubstate = {published},
tppubtype = {article}
}
Objectives: Malaria is still one of the main reasons for hospitalization in children living in sub-Saharan Africa. Rapid risk stratification at admission is essential for optimal medical care and improved prognosis. Whereas coma, deep breathing, and, to a lesser degree, severe anemia are established predictors of malaria-related death, the value of assessing prostration for risk stratification is less certain. Methods: Here we used a retrospective multi-center analysis comprising over 33,000 hospitalized children from four large studies, including two observational studies from the Severe Malaria in African Children network, a randomized controlled treatment study, and the phase-3-clinical RTS,S-malaria vaccine trial, to evaluate known risk factors of mortality and with a specific emphasis on the role of prostration. Results: Despite comparable age profiles of the participants, we found significant inter- and intra-study variation in the incidence of fatal malaria as well as in the derived risk ratios associated with the four risk factors: coma, deep breathing, anemia, and prostration. Despite pronounced variations, prostration was significantly associated with an increased risk of mortality (P <0.001) and its consideration resulted in improved predictive performance, both in a multivariate model and a univariate model based on the Lambaréné Organ Dysfunction Score. Conclusion: Prostration is an important clinical criterion to determine severe pediatric malaria with possible fatal outcomes. |
