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Overview :
The fatality rate of cerebral malaria in children is high
(often in the order of 20-30%) despite aggressive therapy. Most deaths (75%)
occurred within 24 hours of admission. Several clinical or laboratory
indicators can be used to predict serious outcomes.
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Indicators
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Odds Ratio
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cold periphery (hands and/or feet feeling colder to touch
than the rest of the body)
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2.7
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deep coma (Blantyre
coma score 0 or 1) on admission
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2.0
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hypoglycemia (blood glucose < 2.2 mmol/L) on admission
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4.1
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urea > 6.4 mmol/L
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2.8
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More than 90% of children who died had at least one of these
conditions.
Additional indicators of death:
(1) abnormal respiratory pattern (abnormally deep or irregular
breathing)
(2) rapid pulse rate (>= 160 breaths per minute)
(3) elevated AST
(4) elevated lactate
(5) multiple episodes of hypoglycemia during stay
(6) multiple convulsions during stay
Predictors of neurologic sequelae:
(1) multiple convulsions during stay
(2) deep coma (Blantyre
coma score of 0 or 1)
(3) duration of unconsciousness
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