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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Using malarial retinopathy to improve the classification of children with cerebral malaria
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 102, No. 11, Year 2008
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Description
The mechanisms leading to death in cerebral malaria (CM) remain unclear. We compared clinical and laboratory data among children with CM, categorized by ocular fundus findings, to elucidate differences that suggest different underlying pathological processes. From 1999-2005, standard examinations, treatment and record keeping were used for children with a clinical diagnosis of CM. Children were divided into ocular subgroups: normal fundus (N), malarial retinopathy (R), or papilloedema alone (P) and appropriate statistical tests were used to compare clinical and laboratory findings among groups. Eight hundred and eighty children who had eye examinations within 6 h of admission were included in the analysis. The groups differed significantly in case-fatality rates: Group P, 44.4% (95% CI 25.3-63.2), Group R, 18.0% (95% CI 15.6-22.3) and Group N, 7.0% (95% CI 4.2-9.8). There were also significant differences among the groups in blood pressure, prevalence of deep breathing, haematocrit, parasite density, platelet concentration and, among survivors, hours taken to recover from coma. Differences among groups suggest that different underlying pathophysiological processes are operating in children with CM defined by existing criteria. Our proposed classification, by improving the specificity of diagnosis, would enhance consistency among different study sites and prove useful in future research studies. © 2008 Royal Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Lewallen, Susan
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Canada, Vancouver
The University of British Columbia
Bronzan, Rachel N.
Malawi, Zomba
University of Malawi
United States, East Lansing
Msu College of Osteopathic Medicine
Beare, Nicholas A.V.
United Kingdom, Liverpool
Royal Liverpool University Hospital
Malawi, Zomba
University of Malawi
Harding, Simon P.
Malawi, Zomba
University of Malawi
Molyneux, Malcolm Edward
Malawi, Zomba
University of Malawi
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Taylor, Terrie Ellen
Malawi, Zomba
University of Malawi
United States, East Lansing
Msu College of Osteopathic Medicine
Statistics
Citations: 85
Authors: 6
Affiliations: 6
Identifiers
Doi:
10.1016/j.trstmh.2008.06.014
ISSN:
00359203
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cross Sectional Study