Faculty Opinions recommendation of Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial.

2006 ◽  
Author(s):  
Tomas Jelinek
Keyword(s):  
Falciparum Malaria ◽  
Randomised Trial ◽  
Severe Falciparum Malaria

scholarly journals Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial

The Lancet ◽  
2010 ◽  
Vol 376 (9753) ◽  
pp. 1647-1657 ◽  
Author(s):  
Arjen M Dondorp ◽  
Caterina I Fanello ◽  
Ilse CE Hendriksen ◽  
Ermelinda Gomes ◽  
Amir Seni ◽  
...  
Keyword(s):  
Falciparum Malaria ◽  
Randomised Trial ◽  
Open Label ◽  
African Children ◽  
Severe Falciparum Malaria

scholarly journals Identifying prognostic factors of severe metabolic acidosis and uraemia in African children with severe falciparum malaria: a secondary analysis of a randomized trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Mzumara ◽  
Stije Leopold ◽  
Kevin Marsh ◽  
Arjen Dondorp ◽  
Eric O. Ohuma ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Metabolic Acidosis ◽  
Falciparum Malaria ◽  
Model Building ◽  
Statistical Significance ◽  
Severe Metabolic Acidosis ◽  
African Countries ◽  
Prognostic Features ◽  
African Children ◽  
Severe Falciparum Malaria

Abstract Background Severe metabolic acidosis and acute kidney injury are major causes of mortality in children with severe malaria but are often underdiagnosed in low resource settings. Methods A retrospective analysis of the ‘Artesunate versus quinine in the treatment of severe falciparum malaria in African children’ (AQUAMAT) trial was conducted to identify clinical features of severe metabolic acidosis and uraemia in 5425 children from nine African countries. Separate models were fitted for uraemia and severe metabolic acidosis. Separate univariable and multivariable logistic regression were performed to identify prognostic factors for severe metabolic acidosis and uraemia. Both analyses adjusted for the trial arm. A forward selection approach was used for model building of the logistic models and a threshold of 5% statistical significance was used for inclusion of variables into the final logistic model. Model performance was assessed through calibration, discrimination, and internal validation with bootstrapping. Results There were 2296 children identified with severe metabolic acidosis and 1110 with uraemia. Prognostic features of severe metabolic acidosis among them were deep breathing (OR: 3.94, CI 2.51–6.2), hypoglycaemia (OR: 5.16, CI 2.74–9.75), coma (OR: 1.72 CI 1.17–2.51), respiratory distress (OR: 1.46, CI 1.02–2.1) and prostration (OR: 1.88 CI 1.35–2.59). Features associated with uraemia were coma (3.18, CI 2.36–4.27), Prostration (OR: 1.78 CI 1.37–2.30), decompensated shock (OR: 1.89, CI 1.31–2.74), black water fever (CI 1.58. CI 1.09–2.27), jaundice (OR: 3.46 CI 2.21–5.43), severe anaemia (OR: 1.77, CI 1.36–2.29) and hypoglycaemia (OR: 2.77, CI 2.22–3.46) Conclusion Clinical and laboratory parameters representing contributors and consequences of severe metabolic acidosis and uraemia were independently associated with these outcomes. The model can be useful for identifying patients at high risk of these complications where laboratory assessments are not routinely available.

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