ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Acute Kidney Injury Interacts With Coma, Acidosis, and Impaired Perfusion to Significantly Increase Risk of Death in Children With Severe Malaria.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 42 citations in OpenAlex.
- Cerebral Malaria and Severe Malarial Anemia, but not Other Forms of Severe Malaria, Are Associated With Long-Term Cognitive Impairment.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Prevalence of Plasmodium ovale and Plasmodium malariae Mixed Infections and Associated Mortality in Children with Severe Falciparum Malaria.The American journal of tropical medicine and hygiene · 2026Article
- Article
- Intestinal Barrier Loss Enables Microbiota-Mediated Purinergic Suppression During Malaria.bioRxiv : the preprint server for biology · 2026Article
- Altered natural killer cell function in children with severe malaria.ImmunoHorizons · 2026Article
- Severe malarial anaemia in childhood is associated with decreased long-term household wealth.BMC public health · 2025Article
- Gut bacterial dysbiosis in pediatric severe malaria associates with post-discharge mortality.Nature communications · 2025Article
- Manual Single-Lumen Alternating Microbatch Dialysis to Deplete Stored Blood Potassium: A Potential Use for Children with Severe Malaria-Associated Acute Kidney Injury.The American journal of tropical medicine and hygiene · 2025Article
- Elevated uric acid levels, mortality and cognitive impairment in children with severe malaria.Nature medicine · 2025Article
- Low prevalence of helminth infection in Ugandan children hospitalized with severe malaria.PloS one · 2025Article
- Multiple Organ Dysfunction Syndrome in Malawian Children with Cerebral Malaria.The American journal of tropical medicine and hygiene · 2024Article
- Severe Malaria in Angola: The Clinical Profile and Disease Outcome Among Adults from a Low-Endemic Area.Biomedicines · 2024Article
- Low prevalence of soil transmitted helminth infection in Ugandan children hospitalized with severe malaria.medRxiv : the preprint server for health sciences · 2024Article
- Non-falciparum malaria infections in Uganda, does it matter? A review of the published literature.Malaria journal · 2024Review
- Severe malaria intervention status in Nigeria: workshop meeting report.Malaria journal · 2024Article
- sTREM-1: A Biomarker of Mortality in Severe Malaria Impacted by Acute Kidney Injury.The Journal of infectious diseases · 2024Article
- Xanthine oxidase levels and immune dysregulation are independently associated with anemia in Plasmodium falciparum malaria.Scientific reports · 2023Article
- Post-Discharge Mortality in Recently Hospitalized African Children: A Hidden Crisis.The American journal of tropical medicine and hygiene · 2023Article
- Genome-wide liver transcriptomic profiling of a malaria mouse model reveals disturbed immune and metabolic responses.Parasites & vectors · 2023Article
- Blood biomarkers of neuronal injury in paediatric cerebral malaria and severe malarial anaemia.Brain communications · 2023Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMortality in severe malaria remains high in children treated with intravenous artesunate. Acute kidney injury (AKI) is a common complication of severe malaria, but the interactions between AKI and other complications on the risk of mortality in severe malaria are not well characterized.
methodsBetween 2014 and 2017, 600 children aged 6-48 months to 4 years hospitalized with severe malaria were enrolled in a prospective clinical cohort study evaluating clinical predictors of mortality in children with severe malaria.
resultsThe mean age of children in this cohort was 2.1 years (standard deviation, 0.9 years) and 338 children (56.3%) were male. Mortality was 7.3%, and 52.3% of deaths occurred within 12 hours of admission. Coma, acidosis, impaired perfusion, AKI, elevated blood urea nitrogen (BUN), and hyperkalemia were associated with increased mortality (all P < .001). AKI interacted with each risk factor to increase mortality (P < .001 for interaction). Children with clinical indications for dialysis (14.4% of all children) had an increased risk of death compared with those with no indications for dialysis (odds ratio, 6.56; 95% confidence interval, 3.41-12.59).
conclusionsAKI interacts with coma, acidosis, or impaired perfusion to significantly increase the risk of death in severe malaria. Among children with AKI, those who have hyperkalemia or elevated BUN have a higher risk of death. A better understanding of the causes of these complications of severe malaria, and development and implementation of measures to prevent and treat them, such as dialysis, are needed to reduce mortality in severe malaria.
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