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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Clinical features and prognostic indicators in paediatric cerebral malaria: A study of 131 comatose malawian children
QJM, Volume 71, No. 2, Year 1989
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Description
We studied the relationship between presenting features and outcome in 131 Malawian children admitted with cerebral malaria (P. falciparum malaria and unrousable coma). A method was devised for the measurement of depth of coma in children too young to speak. Twenty patients (15 per cent) died and 12 (9 per cent) recovered with residual neurological sequelae. Presenting clinical signs significantly associated with adverse outcome (death or sequelae) were profound coma, signs of decerebration, absence of corneal reflexes, convulsions at the time of admission and age under three years. Laboratory findings of prognostic significance were hypoglycemia, leucocytosis, hyperparasitaemia, elevated plasma concentrations of alanine and 5 -nucleotidase, and elevated plasma or cerebrospinal fluid lactate. A prognostic index based on eight of these risk factors that can readily be ascertained at the bedside or in a ward sideroom, was more accurately predictive of outcome than any single feature. Such an index may be valuable as a measure of severity of illness for establishing the comparability of study groups, and for evaluating the role of other factors in the pathogenesis of cerebral malaria. © 1991 Oxford University Press.
Authors & Co-Authors
Molyneux, Malcolm Edward
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Taylor, Terrie Ellen
United States, East Lansing
Michigan State University
Wirima, Jack J.
Malawi, Lilongwe
Kamuzu Central Hospital
Borgstein, Arabella
Malawi, Blantyre
Queen Elizabeth Central Hospital Malawi
Statistics
Citations: 715
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.1093/oxfordjournals.qjmed.a068338
ISSN:
14602725
e-ISSN:
14602393
Research Areas
Infectious Diseases
Maternal And Child Health