Mortality patterns and site heterogeneity of severe malaria in African children.
Mortality patterns and site heterogeneity of severe malaria in African children.
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DOI：
10.1371/journal.pone.0058686
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Kremsner PG
中科院分区：
文献类型：
--
作者：
Kendjo E;Agbenyega T;Bojang K;Newton CR;Bouyou-Akotet M;Pedross F;Kombila M;Helbok R;Kremsner PG
在这项研究中，我们的目的是评估在撒哈拉以南非洲严重恶性疟原虫疟疾儿童的早期，中期和晚期死亡率预测的网站异质性。分析了2000年12月至2005年5月期间在六个医院研究中心收治的26,036名严重恶性疟原虫疟疾儿童的医疗记录。比较各组和幸存者之间24小时内（早期）、24 - 47小时（中期）和此后（48小时或更晚，晚期死亡）死亡儿童的人口统计学、临床和实验室数据。总死亡率为4.3%（N = 1，129）。 各研究中心的中位至死亡时间各不相同（P<0·001），范围从Lambaréné的8小时（3小时-52小时）到Kilifi的40小时（10小时-100小时）。58%的死亡发生在24小时内，中晚期死亡率分别为19%和23%。合并所有部位，深呼吸、虚脱和低血糖是早期、中期和晚期死亡率的独立预测因素（P<0.01）。研究部位特异性早期死亡的独立预测因素包括所有部位的虚脱、昏迷和深呼吸（P<0.001）。研究中心特异性中晚期死亡的独立预测因子在研究中心之间差异很大（P<0.001），包括1 - 7个不同的临床和实验室变量。在非洲严重疟疾儿童中，死亡率预测的地点异质性是明显的。早期死亡率的预测具有最高的一致性之间的网站。
In this study we aimed to assess site heterogeneity of early, intermediate, and late mortality prediction in children with severe Plasmodium falciparum malaria in sub-Saharan Africa. Medical records of 26,036 children admitted with severe Plasmodium falciparum malaria in six hospital research centers between December 2000 to May 2005 were analyzed. Demographic, clinical and laboratory data of children who died within 24 hours (early), between 24 and 47 hours (intermediate) and thereafter (48 hours or later, late mortality) were compared between groups and survivors. Overall mortality was 4·3% (N = 1,129). Median time to death varied across sites (P<0·001), ranging from 8h (3h–52h) in Lambaréné to 40h (10h–100h) in Kilifi. Fifty-eight percent of deaths occurred within 24 hours and intermediate and late mortality rate were 19% and 23%, respectively. Combining all sites, deep breathing, prostration and hypoglycemia were independent predictors for early, intermediate and late mortality (P<0·01). Site specific independent predictors for early death included prostration, coma and deep breathing at all sites (P<0·001). Site specific independent predictors for intermediate and late death largely varied between sites (P<0·001) and included between 1 and 7 different clinical and laboratory variables. Site heterogeneity for mortality prediction is evident in African children with severe malaria. Prediction for early mortality has the highest consistency between sites.
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影响因子：
3
作者：
Roca-Feltrer, Arantxa;Carneiro, Ilona;Schellenberg, David
通讯作者：
Schellenberg, David
影响因子：
--
作者：
Biai, Sidu;Rodrigues, Amabelia;Aaby, Peter
通讯作者：
Aaby, Peter
影响因子：
12.7
作者：
Rowe, Alexander K.;Onikpo, Faustin;Deming, Michael S.
通讯作者：
Deming, Michael S.
影响因子：
11.8
作者：
WALLER, D;KRISHNA, S;WHITE, NJ
通讯作者：
WHITE, NJ
影响因子：
6.4
作者：
Kremsner, Peter Gottfried;Valim, Clarissa;Taylor, Terrie
通讯作者：
Taylor, Terrie