ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2010
A simple score to predict the outcome of severe malaria in adults.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.
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Who cites it
54 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic models for the clinical management of malaria and its complications: a systematic review.BMJ open · 2019Pooled it
- The Safety of a Conservative Fluid Replacement Strategy in Adults Hospitalised with Malaria.PloS one · 2015Trial
- Predicting the clinical outcome of severe falciparum malaria in african children: findings from a large randomized trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012Trial
- Clinical Spectrum and Admission Correlates of Complicated Imported Malaria in Polish Travellers: An 11-Year Retrospective Analysis with Geographic Mapping of Travel Destinations.Journal of clinical medicine · 2026Article
- Article
- "Referral patterns and associated factors among adult patients admitted with Severe Malaria at Shedeho Meket Primary Hospital, Northeast Ethiopia".BMC infectious diseases · 2026Article
- Reprogramming of host energy metabolism mediated by the TNF-iNOS-HIF-1α axis plays a key role in host resistance tobioRxiv : the preprint server for biology · 2026Article
- Management and monitoring strategies for severe cerebral malaria: a guide for the intensivist.Annals of intensive care · 2025Review
- Severe falciparum malaria in pregnancy in Southeast Asia: a multi-centre retrospective cohort study.BMC medicine · 2023Article
- Delayed presentation to hospital care is associated with sequelae but not mortality in children with cerebral malaria in Malawi.Malaria journal · 2022Article
- Factors Associated with Prolonged Hospital Length of Stay in Adults with Imported Falciparum Malaria-An Observational Study from a Tertiary Care University Hospital in Berlin, Germany.Microorganisms · 2021Article
- Etiology of lactic acidosis in malaria.PLoS pathogens · 2021Review
- Treatment Outcome of Severe Malaria and Associated Factors among Adults Admitted in Arba Minch General Hospital, Southern Nation Nationality and People's Region, Ethiopia.Journal of parasitology research · 2021Article
- Article
- Severe malaria. Current concepts and practical overview: What every intensivist should know.Intensive care medicine · 2020Review
- Article
- Does reduced oxygen delivery cause lactic acidosis in falciparum malaria? An observational study.Malaria journal · 2019Observational
- The Critical Care Society of Southern Africa Consensus Statement on ICU Triage and Rationing (ConICTri).The Southern African journal of critical care : the official journal of the Critical Care Society · 2019Article
- Imported severe malaria and risk factors for intensive care: A single-centre retrospective analysis.PloS one · 2019Article
- Observational
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20 authors.
Funding
Abstract
backgroundWorld Health Organization treatment guidelines recommend that adults with severe malaria be admitted to an intensive care unit (ICU). However, ICU facilities are limited in the resource-poor settings where most malaria occurs. Identification of patients at greater risk of complications may facilitate their triage and resource allocation.
methodsWith use of data from a trial conducted in Southeast Asia (n=868), a logistic regression model was built to identify independent predictors of mortality among adults with severe malaria. A scoring system based on this model was tested in the original dataset and then validated in 2 series from Bangladesh (n=188) and Vietnam (n=292).
resultsAcidosis (base deficit) and cerebral malaria (measured as Glasgow Coma Score) were the main independent predictors of outcome. The 5-point Coma Acidosis Malaria (CAM) score was simply derived from these 2 variables. Mortality increased steadily with increasing score. A CAM score <2 predicted survival with a positive predictive value (PPV) of 95.8% (95% confidence interval [CI], 93%- 97.7%). Of the 14 of 331 patients who died with a CAM score <2, 11 (79%) had renal failure and death occurred late after hospital admission (median, 108 h; range, 40-360 h). Substitution of plasma bicarbonate as the measure of acidosis only slightly reduced the prognostic value of the model. Use of respiratory rate was inferior, but a score <2 still predicted survival with a PPV of 92.2% (95% CI, 89.1%-94.7%).
conclusionsPatients with a CAM score <2 at hospital admission may be safely treated in a general ward, provided that renal function can be monitored.
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