Pathophysiology of severe malaria in children. by Maitland, K, Marsh, K

“…Over the past decade there has been a growing recognition that the rationalization of severe malaria in children into the two major syndromes of cerebral malaria and severe malaria anaemia is much too simplistic. …”

Intravenous fluids for seriously ill children. by Maitland, K, Newton, C, English, M

Hypokalemia in children with severe falciparum malaria. by Maitland, K, Pamba, A, Newton, C, Lowe, B, Levin, M

“…At admission, serum potassium was normal (3-5.5 mmol/L) in 31 (81.6%) and low (<3 mmol/L) in four (11%) children, and three (6.3%) children had hyperkalemia (>5.5 mmol/L). …”

A predictive algorithm for identifying children with sickle cell anemia among children admitted to hospital with severe anemia in Africa by Olupot-Olupot, P, Connon, R, Kiguli, S, Opoka, RO, Alaroker, F, Uyoga, S, Nakuya, M, Okiror, W, Nteziyaremye, J, Ssenyondo, T, Nabawanuka, E, Kayaga, J, Williams, C, Amorut, D, Muhindo, R, Frost, G, Walsh, K, Macharia, AW, Gibb, DM, Walker, AS, George, EC, Maitland, K, Williams, TN

“…Most outcomes, including mortality and readmission, were better in children with either known or unknown-SCA than non-SCA children. …”

Transfusion volume for children with severe anemia in Africa by Maitland, K, Saunders, D, Olupot-Olupot, P, Kiguli, S, Chagaluka, G, Alaroker, F, Opoka, OR, Mpoya, A, Engoru, C, Nteziyaremye, J, Mallewa, M, Kennedy, N, Nakuya, M, Namayanja, C, Kayaga, J, Uyoga, S, Byabazaire, D, M’baya, B, Wabwire, B, Frost, G, Bates, I, Evans, JA, Williams, TN, Goncalves, P, George, EC, Gibb, DM, Walker, AS, for the TRACT Group

“…</p> <br/> <p>RESULTS</p> <p>A total of 3196 eligible children (median age, 37 months; 2050 [64.1%] with malaria) were assigned to receive a transfusion of 30 ml per kilogram (1598 children) or 20 ml per kilogram (1598 children) and were followed for 180 days. …”

Transfusion volume for children with severe anemia in Africa by Maitland, K, Olupot-Olupot, P, Kiguli, S, Chagaluka, G, Alaroker, F, Opoka, R, Mpoya, A, Engoru, C, Nteziyaremye, J, Mallewa, M, Kennedy, N, Nakuya, M, Namayanja, C, Kayaga, J, Uyoga, S, Kyeyune Byabazaire, D, M’baya, B, Wabwire, B, Frost, G, Bates, I, Evans, J, Williams, T, Saramago Goncalves, P, George, E, Gibb, D, Walker, A

“…<br/><strong>Results: </strong>A total of 3196 eligible children (median age, 37 months; 2050 [64.1%] with malaria) were assigned to receive a transfusion of 30 ml per kilogram (1598 children) or 20 ml per kilogram (1598 children) and were followed for 180 days. …”

High incidence of malaria in alpha-thalassaemic children. by Williams, T, Maitland, K, Bennett, S, Ganczakowski, M, Peto, T, Newbold, C, Bowden, D, Weatherall, D, Clegg, J

“…Furthermore, this effect is most marked in the youngest children and for the non-lethal parasite Plasmodium vivax. …”

Response to volume resuscitation in children with severe malaria. by Maitland, K, Pamba, A, Newton, C, Levin, M

“… OBJECTIVES: To examine whether hypovolemia is an important cause of the acidosis in children with severe malaria. DESIGN: Prospective phase 1 study examining the safety of volume expansion using detailed hemodynamic monitoring. …”

Characteristics and outcome of cardiopulmonary resuscitation in hospitalised African children. by Olotu, A, Ndiritu, M, Ismael, M, Mohammed, S, Mithwani, S, Maitland, K, Newton, C

“… OBJECTIVE: To review the characteristics and outcome of cardiopulmonary resuscitation in children at a rural hospital in Kenya. PATIENTS AND METHOD: All children aged 0-14 years who experienced &gt; or =1 episode of respiratory or cardiopulmonary arrest during April 2002--2004 were prospectively identified. …”

Plasmodium vivax: a cause of malnutrition in young children. by Williams, T, Maitland, K, Phelps, L, Bennett, S, Peto, T, Viji, J, Timothy, R, Clegg, J, Weatherall, D, Bowden, D

“…We studied the aetiology of malnutrition in a cohort of 1511 children &lt; 10 years old in Espiritu Santo, Vanuatu. …”

Immediate transfusion in African children with uncomplicated severe anemia by Maitland, K, Kiguli, S, Olupot-Olupot, P, Walker, S

“…The children were followed for 180 days, and 71 (4.5%) were lost to follow-up. …”

Plasmodium vivax: a cause of malnutrition in young children. by Williams, T, Maitland, K, Phelps, L, Bennett, S, Peto, T, Viji, J, Timothy, R, Clegg, J, Weatherall, D, Bowden, D

“…We studied the aetiology of malnutrition in a cohort of 1511 children &lt; 10 years old in Espiritu Santo, Vanuatu. …”

Whole blood versus red cell concentrates for children with severe anaemia: a secondary analysis of the Transfusion and Treatment of African Children (TRACT) trial by George, EC, Uyoga, S, M'baya, B, Kyeyune Byabazair, D, Kiguli, S, Olupot-Olupot, P, Opoka, R, Chagaluka, G, Alaroker, F, Williams, TN, Bates, I, Mbanya, D, Gibb, DM, Walker, AS, Maitland, K

“…<p><strong>Background:</strong> The TRACT trial established the timing of transfusion in children with uncomplicated anaemia (haemoglobin 4–6 g/dL) and the optimal volume (20 vs 30 mL/kg whole blood or 10 vs 15 mL/kg red cell concentrates) for transfusion in children admitted to hospital with severe anaemia (haemoglobin <6 g/dL) on day 28 mortality (primary endpoint). …”

Bacteremia among children admitted to a rural hospital in Kenya. by Berkley, J, Lowe, B, Mwangi, I, Williams, T, Bauni, E, Mwarumba, S, Ngetsa, C, Slack, M, Njenga, S, Hart, C, Maitland, K, English, M, Marsh, K, Scott, J

“…The minimal annual incidence of community-acquired bacteremia was estimated at 1457 cases per 100,000 children among infants under a year old, 1080 among children under 2 years, and 505 among children under 5 years. …”

Management of severe malaria in children: proposed guidelines for the United Kingdom by Maitland, K, Nadel, S, Pollard, A, Williams, T, Newton, C, Levin, M

“…In uncomplicated disease, the clinical features of malaria are similar in children and adults, but in severe disease, the clinical spectrum, complications, and management differ and merit the development of separate guidelines for children. …”

Severe P. falciparum malaria in Kenyan children: evidence for hypovolaemia. by Maitland, K, Levin, M, English, M, Mithwani, S, Peshu, N, Marsh, K, Newton, C

“…METHODS: We studied 515 children admitted with severe malaria to a high-dependency unit (HDU) in Kilifi, Kenya. …”

Research priorities in the management of severe Plasmodium falciparum malaria in children. by Idro, R, Aketch, S, Gwer, S, Newton, C, Maitland, K

“…This review covers the priority areas for research in the care of children with severe malaria, addressing each of the main risk factors associated with death, in a bid to reduce the inpatient mortality.…”

Transfusion timing and volume in African children with severe anemia. Reply. by Maitland, K, Olupot-Olupot, P, Walker, A

Haemodynamic status and management of shock in children with severe febrile illness by Akech, S

“…However, fluid bolus resuscitation results in increased mortality compared to no bolus (control) in children in SSA. This finding excludes children with gastroenteritis, trauma, burns, and malnutrition. …”

Management of severe malaria in children: proposed guidelines for the United Kingdom. by Maitland, K, Nadel, S, Pollard, A, Williams, T, Newton, C, Levin, M

“…Malaria is the most important imported mosquito borne infection in the United Kingdom As preventive measures are never 100% effective, malaria should be suspected in any patient with "flu-like symptoms" who has travelled to malarious areas within a year Most cases of severe malaria result from a failure to expedite prompt "same day" diagnosis and initiate appropriate treatment in patients with suspected malaria Oral quinine and chloroquine or pyrimethamine with sulfadoxine should never be prescribed to treat falciparum malaria in children In children, the development of one or more features of severe or complicated malaria constitutes a medical emergency The emergency assessment of a child with severe malaria should follow the structured approach advocated by the Advanced Paediatric Life Support guidelines If in doubt: admit, monitor closely, and seek specialist advice.…”