ArticleCritical care (London, England)2015
The role of previously unmeasured organic acids in the pathogenesis of severe malaria.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 21 citations in OpenAlex.
- Identifying prognostic factors of severe metabolic acidosis and uraemia in African children with severe falciparum malaria: a secondary analysis of a randomized trial.Malaria journal · 2021Trial
- Application of a Non-Targeted Metabolomics Study inInternational journal of molecular sciences · 2025Article
- In vitro cultured malaria hypnozoites leave a footprint of specific metabolites.PLoS pathogens · 2025Article
- Longitudinal associations of plasma amino acid levels with recovery from malarial coma.Malaria journal · 2024Observational
- Longitudinal associations of plasma amino acid levels with recovery from malarial coma.Research square · 2024Article
- Pediatric Malaria with Respiratory Distress: Prognostic Significance of Point-of-Care Lactate.Microorganisms · 2023Article
- Severe malaria.Malaria journal · 2022Review
- Etiology of lactic acidosis in malaria.PLoS pathogens · 2021Review
- Predictors of outcome in childhoodVirulence · 2020Review
- Evaluating lactate prognostic value in children suspected of acetaminophen-induced liver failure in Liberia.Pediatric research · 2020Article
- Clinical trials to assess adjuvant therapeutics for severe malaria.Malaria journal · 2020Article
- Identifying the Components of Acidosis in Patients With Severe Plasmodium falciparum Malaria Using Metabolomics.The Journal of infectious diseases · 2019Observational
- Acidosis and acute kidney injury in severe malaria.Malaria journal · 2018Article
- Erratum to: the role of previously unmeasured organic acids in the pathogenesis of severe malaria.Critical care (London, England) · 2015Article
- Article
Corrections and comments
- Erratum issuedErratum to: the role of previously unmeasured organic acids in the pathogenesis of severe malaria.2015 · Ghose, Aniruddha [added]
Authors and funding
22 authors at 7 institutions in 4 countries.
Funding
Abstract
introductionSevere falciparum malaria is commonly complicated by metabolic acidosis. Together with lactic acid (LA), other previously unmeasured acids have been implicated in the pathogenesis of falciparum malaria.
methodsIn this prospective study, we characterised organic acids in adults with severe falciparum malaria in India and Bangladesh. Liquid chromatography-mass spectrometry was used to measure organic acids in plasma and urine. Patients were followed until recovery or death.
resultsPatients with severe malaria (n=138), uncomplicated malaria (n=102), sepsis (n=32) and febrile encephalopathy (n=35) were included. Strong ion gap (mean ± SD) was elevated in severe malaria (8.2 mEq/L ± 4.5) and severe sepsis (8.6 mEq/L ± 7.7) compared with uncomplicated malaria (6.0 mEq/L ± 5.1) and encephalopathy (6.6 mEq/L ± 4.7). Compared with uncomplicated malaria, severe malaria was characterised by elevated plasma LA, hydroxyphenyllactic acid (HPLA), α-hydroxybutyric acid and β-hydroxybutyric acid (all P<0.05). In urine, concentrations of methylmalonic, ethylmalonic and α-ketoglutaric acids were also elevated. Multivariate logistic regression showed that plasma HPLA was a strong independent predictor of death (odds ratio [OR] 3.5, 95 % confidence interval [CI] 1.6-7.5, P=0.001), comparable to LA (OR 3.5, 95 % CI 1.5-7.8, P=0.003) (combined area under the receiver operating characteristic curve 0.81).
conclusionsNewly identified acids, in addition to LA, are elevated in patients with severe malaria and are highly predictive of fatal outcome. Further characterisation of their sources and metabolic pathways is now needed.
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