Prostration and the prognosis of death in African children with severe malaria
<p><i>Objectives:</i> 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, s...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2023
|
| _version_ | 1797111268144840704 |
|---|---|
| author | Agnandji, ST Recker, M Mordmüller, B Glöckner, S Adegnika, AA Lell, B Otieno, L Otieno, W Owusu-Agyei, S Asante, KP Agbenyega, T Ansong, D Macete, E Aide, P Sorgho, H Tinto, H Mturi, N Lusingu, JPA Gesase, S Hoffman, I Masoud, NS Newton, CR Bojang, K Krause, G Kremsner, PG |
| author_facet | Agnandji, ST Recker, M Mordmüller, B Glöckner, S Adegnika, AA Lell, B Otieno, L Otieno, W Owusu-Agyei, S Asante, KP Agbenyega, T Ansong, D Macete, E Aide, P Sorgho, H Tinto, H Mturi, N Lusingu, JPA Gesase, S Hoffman, I Masoud, NS Newton, CR Bojang, K Krause, G Kremsner, PG |
| author_sort | Agnandji, ST |
| collection | OXFORD |
| description | <p><i>Objectives:</i> 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.</p>
<p><i>Methods:</i> 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.</p>
<p><i>Results:</i> 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 (<i>P</i> <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.</p>
<p><i>Conclusion:</i> Prostration is an important clinical criterion to determine severe pediatric malaria with possible fatal outcomes.</p> |
| first_indexed | 2024-03-07T08:07:55Z |
| format | Journal article |
| id | oxford-uuid:4541eec2-43f6-4b85-8d67-e0201903c0b1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:07:55Z |
| publishDate | 2023 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:4541eec2-43f6-4b85-8d67-e0201903c0b12023-11-09T16:12:21ZProstration and the prognosis of death in African children with severe malariaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4541eec2-43f6-4b85-8d67-e0201903c0b1EnglishSymplectic ElementsElsevier2023Agnandji, STRecker, MMordmüller, BGlöckner, SAdegnika, AALell, BOtieno, LOtieno, WOwusu-Agyei, SAsante, KPAgbenyega, TAnsong, DMacete, EAide, PSorgho, HTinto, HMturi, NLusingu, JPAGesase, SHoffman, IMasoud, NSNewton, CRBojang, KKrause, GKremsner, PG<p><i>Objectives:</i> 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.</p> <p><i>Methods:</i> 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.</p> <p><i>Results:</i> 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 (<i>P</i> <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.</p> <p><i>Conclusion:</i> Prostration is an important clinical criterion to determine severe pediatric malaria with possible fatal outcomes.</p> |
| spellingShingle | Agnandji, ST Recker, M Mordmüller, B Glöckner, S Adegnika, AA Lell, B Otieno, L Otieno, W Owusu-Agyei, S Asante, KP Agbenyega, T Ansong, D Macete, E Aide, P Sorgho, H Tinto, H Mturi, N Lusingu, JPA Gesase, S Hoffman, I Masoud, NS Newton, CR Bojang, K Krause, G Kremsner, PG Prostration and the prognosis of death in African children with severe malaria |
| title | Prostration and the prognosis of death in African children with severe malaria |
| title_full | Prostration and the prognosis of death in African children with severe malaria |
| title_fullStr | Prostration and the prognosis of death in African children with severe malaria |
| title_full_unstemmed | Prostration and the prognosis of death in African children with severe malaria |
| title_short | Prostration and the prognosis of death in African children with severe malaria |
| title_sort | prostration and the prognosis of death in african children with severe malaria |
| work_keys_str_mv | AT agnandjist prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT reckerm prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT mordmullerb prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT glockners prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT adegnikaaa prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT lellb prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT otienol prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT otienow prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT owusuagyeis prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT asantekp prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT agbenyegat prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT ansongd prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT macetee prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT aidep prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT sorghoh prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT tintoh prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT mturin prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT lusingujpa prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT gesases prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT hoffmani prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT masoudns prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT newtoncr prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT bojangk prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT krauseg prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria AT kremsnerpg prostrationandtheprognosisofdeathinafricanchildrenwithseveremalaria |