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Overview :
While the risk for severe malaria in endemic areas is greater in
children, the risk is different for a nonimmune individual. This has
implications for tourists from developed countries who travels to an endemic
area. The authors are from the TropNetEurop and SIMPID surveillance groups.
Patient selection: nonimmune patient with falciparum malaria
Outcomes in severe malaria:
(1) cerebral malaria
(2) prolonged hospitalization
(3) death
Risk factors for severe malaria:
(1) age
>= 40 years of age, with significant risk if >= 70 years of age (Table 2,
page 993).
(2) female
gender (for cerebral malaria)
(3) failure
to take chemoprophylaxis
where:
• In the
discussion an age >= 60 ("old age") was considered a risk factor for severe
malaria. In the implementation I will assign 1 point for 40 to 59, 2 points for
60 to 69 and 3 points for >= 70 years of age.
• The
discussion on page 994 links comorbid disease to age and the risk of severe
disease, but this did not appear to be included in the data analysis. I will add
severe comorbid disease as a risk factor in the implementation.
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