From: Clinical and epidemiological aspects of complicated malaria in Colombia, 2007–2013
Criteria | Defined before 2010 [22] | Defined after 2010 [21]a |
---|---|---|
Cerebral malaria | Impaired consciousness or coma (Blantyre score < 3 or Glasgow score < 9); unconsciousness with the possibility of waking up | Unchanged |
Renal dysfunction | Serum creatinine > 3.0 mg/dL and/or urine vol < 400 mL in 24 h (adults) or <12 mL/kg of body weight in 24 h (children) | Serum creatinine > 1.5 mg/dL |
Hepatic dysfunction | Serum bilirubin > 3 mg/dL and altered liver function tests | Serum bilirubin > 1.5 mg/dL or aminotransferases > 40 U/L |
Respiratory distress | Increased respiratory rate at admission, presence of abnormal lung sounds or pulmonary oedema (X-rays) | Unchanged |
Circulatory collapse or shock | SBP < 70 mm Hg in adults or <50 mm Hg in children (3–5 years) | SBP < 80 mm Hg in adults |
Hyperemesis | >5 episodes in 24 h | Not applicableb |
Hyperpyrexia | Axillary temperature >39.5 °C | Not applicableb |
Hypoglycaemia | Blood glucose level < 40 mg/dL. | Blood glucose level < 60 mg/dL |
Severe anaemia | Haemoglobin < 5 g/dL or haematocrit < 15 % | Haemoglobin < 7 g/dL |
DIC | Abnormal bleeding in the presence of laboratory evidence of DIC | Unchanged |
Acidaemia/acidosis and hyperlactemia | Acidaemia/acidosis (clinical signs) | Plasmatic bicarbonate < 15 mmol/L or base excess > −10; acidaemia pH <7.35; lactate acid > 5 mmol/L |
Haemoglobinuria | Macroscopic haemoglobinuria | Macroscopic haemoglobinuria and positive urine dipstick |
Hyperparasitaemia | >100,000 asexual parasites/μL of P. falciparum or in mixed infection with P. vivax and schizontaemia | >50,000 asexual parasites/μL |