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Title: | Prognostic Value of Circulating Pigmented Cells in African Children with Malaria |
Authors: | Agbenyega, Edward Tsiri Kremsner, Peter Gottfried Taylor, Terrie Valim, Clarissa Missinou, Michel A. Olola, Christopher Krishna, Sanjeev Issifou, Saadou Kombila, Maryvonne Bwanaisa, Lloyd Mithwani, Sadik Newton, Charles R. Pinder, Margaret Bojang, Kalifa Wypij, David |
Issue Date: | 14-Apr-2008 |
Publisher: | Infectious Diseases Society of America |
Citation: | Infectious Diseases Society of America, 2008 |
Abstract: | Background. Plasmodium falciparum malaria is a common cause of morbidity in African children, but identifying
those who are likely to die is problematic. Previous studies suggested that circulating malarial pigment might be a
useful predictor of severity, but none were large enough to detect any association with mortality.
Methods. We used thick blood smears performed on admission for 26,296 children hospitalized with P. falciparum
at 1 of 6 hospitals in the Severe Malaria in African Children network to assess the prognostic value of pigmentcontaining
granulocytes, monocytes, and parasites.
Results. Although at all but one of the study sites the risk of mortality for subjects presenting with 5 pigmented
granulocytes per 200 white blood cells was higher than in subjects with no pigmented granulocytes, adjusted odds
ratios estimated through logistic regression, which included other established markers of severe malaria, suggested
that associations between pigmented cells and mortality were moderate to nonexistent in most sites. The predictive
ability of pigmented cells was low, as measured by the change in the area under the receiver operating characteristic
curve of logistic regression models.
Conclusions. Although high levels of pigmented cells were associated with a fatal outcome in some study sites,
they were not useful predictors of outcome across Africa. |
Description: | This article is published at Infectious Diseases Society of America |
URI: | http://hdl.handle.net/123456789/15684 |
Appears in Collections: | College of Health Sciences
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