Predictors of outcome in childhood Plasmodium falciparum malaria

Abstract

Plasmodium falciparum malaria is classified as either uncomplicated or severe, determining clinical management and providing a framework for understanding pathogenesis. Severe malaria in children is defined by the presence of one or more features associated with adverse outcome, but there is wide variation in the predictive value of these features. Here we review the evidence for the usefulness of these features, alone and in combination, to predict death and other adverse outcomes, and we consider the role that molecular biomarkers may play in augmenting this prediction. We also examine whether a more personalized approach to predicting outcome for specific presenting syndromes of severe malaria, particularly cerebral malaria, has the potential to be more accurate. We note a general need for better external validation in studies of outcome predictors and for the demonstration that predictors can be used to guide clinical management in a way that improves survival and long-term health.

Downregulated mRNA Expression of ZNF385B Is an Independent Predictor of Breast Cancer

“…Therefore, it is of great significance to research new prognosis-related genes for prognosis assessment and treatment guidance for BC and its different subtypes. In our study, low expression of ZNF385B has shown important prognostic value in different subtypes, which might be used to evaluate the risk and prognosis of subgroups and guide beneficial individual treatment options for patients with high risk of death or worse prognosis [24].Currently, surgery has been regarded as an important measure for malignant tumor. However, the possibility of recurrence especially in basal-like BC could adversely influence the outcome of patients.…”

Identifying Prognostic Factors of Severe Metabolic Acidosis and Acute Kidney Injury in African Children with Severe Falciparum Malaria: A Secondary Analysis of A Randomised Trial

“…In children with severe malaria, metabolic acidosis is present in up to 50% of cases, and is strongly associated with a fatal outcome (10,14,15). Metabolic acidosis in Malaria is mainly a result of increased lactate (LA) production from anaerobic glycolysis and to a smaller extent from P. falciparum parasites (5,8).…”

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

“…Despite prompt administration of anti-malarials, 5.8%–24% of childhood deaths from severe malaria occur on the first day of admission [ 2 , 3 ]. Metabolic acidosis and acute kidney injury are two of three (in addition to coma) complications of malaria most predictive for a fatal outcome of severe malaria [ 2 , 4 – 10 ]. However, diagnosis of metabolic acidosis or acute kidney injury requires laboratory facilities beyond the basic test facilities often available.…”

“…In children with severe malaria, metabolic acidosis is present in up to 50% of cases, and is strongly associated with a fatal outcome [ 10 , 14 , 15 ]. Metabolic acidosis in malaria is mainly a result of increased lactate (LA) production from anaerobic glycolysis and to a smaller extent from Plasmodium falciparum parasites [ 5 , 8 ].…”

“…In Uganda, nearly half (45.5%) of children with severe malaria had kidney disease improving global outcomes defined AKI [ 21 ]. Challenges in diagnosing AKI in resource limited settings mean that it is underdiagnosed consequently undertreated, leading to increasing mortality and an increased risk of chronic kidney injury and neurocognitive disorders [ 4 , 10 , 21 – 23 ].…”