Materiały źródłowe

• #1 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  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 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.

• #2 Prognostic indicators in adults hospitalized with falciparum malaria in Western Thailand | Malaria Journal | Full Text

  https://malariajournal.biomedcentral.com/articles/10.1186/1475-2875-12-229

  Severe malaria remains a major cause of death and morbidity amongst adults in the Asiatic tropics. […] Different severity scores and classifications for defining severe malaria were compared and, using multiple logistic regression, simple models for predicting mortality developed. […] The proportion of patients fulfilling the WHO 2000 definition of severe malaria was 78.1%, and their mortality was 10%. […] Models using parameter sets based on WHO 1990, 2000 and Adapted AQ criteria plus blood smear parasite-stage assessment gave the best mortality prediction. […] Prognostic indices based on WHO 2000 definitions, and other simpler indices based on fewer variables, provide clinically useful predictions of outcome in Asian adults with severe malaria. […] The mortality of severe malaria in adults has fallen and the switch from quinine to artesunate has probably been an important contributor.

• #3 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Prognostic markers for mortality and long-term morbidity could have several applications. Foremost, they could help to determine the most appropriate course of action for each individual patient by informing the choice of medical treatment and whether transfer to a medical facility with higher-level care facilities is required. […] Third, identification of children with greatest risk of long-term sequelae could potentially be used to target interventions to reduce the impact of these sequelae on their life, even if the sequelae cannot be prevented. […] In this literature review, we critically evaluate the usefulness of clinical and laboratory features of SM as predictors of mortality and long-term complications in childhood P. falciparum malaria and assess the potential of molecular biomarkers and other approaches to improve the accuracy of prediction. […] We briefly consider the important role of coinfections (human immunodeficiency virus (HIV) and bacteremia) as well as malaria in returning travelers. Finally, we synthesize the existing evidence and propose strategies to improve outcome prediction in pediatric P. falciparum malaria.

• #4 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  The criteria commonly used to define SM were selected because they are associated with adverse outcome, however, they are not all equally good predictors […] One important general caveat is that interpretation of the relationship of prognostic indicators with outcomes is often complicated by the difficulty of knowing whether malaria is the primary or only cause of these features. […] Another caveat is that direct comparison of the Relative Risk (RR), Hazard Ratio (HR), Odds Ratio (OR), and Adjusted Odds Ratio (AOR) for death between studies requires some caution. […] This is particularly evident in the Artesunate versus quinine in the treatment of severe falciparum malaria in African children trial (AQUAMAT) by von Seidlein et al., which showed consistently lower risks of death associated with severity features than other studies examining the same clinical features.

• #5 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  The criteria commonly used to define SM were selected because they are associated with adverse outcome, however, they are not all equally good predictors […] One important general caveat is that interpretation of the relationship of prognostic indicators with outcomes is often complicated by the difficulty of knowing whether malaria is the primary or only cause of these features. […] Another caveat is that direct comparison of the Relative Risk (RR), Hazard Ratio (HR), Odds Ratio (OR), and Adjusted Odds Ratio (AOR) for death between studies requires some caution. […] This is particularly evident in the Artesunate versus quinine in the treatment of severe falciparum malaria in African children trial (AQUAMAT) by von Seidlein et al., which showed consistently lower risks of death associated with severity features than other studies examining the same clinical features.

• #6 Prognostic models for the clinical management of malaria and its complications: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/11/e030793

  The models identified in this review that were used to predict mortality in children with severe malaria have similar clinical predictors. All the models had neurological dysfunction based on either the Glasgow coma score, impaired consciousness, altered mental status, convulsions, decerabration or coma as a predictor. Similarly, in adults, all the models predicting mortality also had neurological dysfunction as a predictor. […] Factors that were predictive of disease severity and mortality seemed to be consistent among these studies. The factors that should therefore be considered by physicians when faced with a patient with malaria infection should include: neurological dysfunction (coma and seizures), acidosis, hypoglycaemia and respiratory distress. […] Models predicting severity and mortality of malaria infection identified in this review have similar predictors. Evidence is, however, lacking on the generalisability of most of these models due lack of external validation. Emphasis should therefore be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

• #7 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Hyperparasitaemia has been associated with an increased likelihood of symptomatic malaria infections as well as malaria-associated mortality. […] Interestingly, in a study of Kenyan children admitted to hospital over a 27-y period during which the incidence of SM declined dramatically, hyperparasitaemia only emerged as a predictor of death during the lowest incidence period. […] Hypoglycemia has been reported in 132% of children presenting to hospital with malaria, with a greater prevalence in children below 3 y of age, those with convulsions or coma, hyperparasitaemia, and those receiving quinine treatment. […] Many studies have demonstrated that hypoglycemia is an important risk factor for death. […] Metabolic acidosis is strongly associated with an increased risk of death. […] Prognosis has been shown to be worse in patients whose lactate levels do not normalize within a few hours of admission and the levels of lactate in fatal cases were nearly double those of survivors.

• #8 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Hyperparasitaemia has been associated with an increased likelihood of symptomatic malaria infections as well as malaria-associated mortality. […] Interestingly, in a study of Kenyan children admitted to hospital over a 27-y period during which the incidence of SM declined dramatically, hyperparasitaemia only emerged as a predictor of death during the lowest incidence period. […] Hypoglycemia has been reported in 132% of children presenting to hospital with malaria, with a greater prevalence in children below 3 y of age, those with convulsions or coma, hyperparasitaemia, and those receiving quinine treatment. […] Many studies have demonstrated that hypoglycemia is an important risk factor for death. […] Metabolic acidosis is strongly associated with an increased risk of death. […] Prognosis has been shown to be worse in patients whose lactate levels do not normalize within a few hours of admission and the levels of lactate in fatal cases were nearly double those of survivors.

• #9 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Hyperparasitaemia has been associated with an increased likelihood of symptomatic malaria infections as well as malaria-associated mortality. […] Interestingly, in a study of Kenyan children admitted to hospital over a 27-y period during which the incidence of SM declined dramatically, hyperparasitaemia only emerged as a predictor of death during the lowest incidence period. […] Hypoglycemia has been reported in 132% of children presenting to hospital with malaria, with a greater prevalence in children below 3 y of age, those with convulsions or coma, hyperparasitaemia, and those receiving quinine treatment. […] Many studies have demonstrated that hypoglycemia is an important risk factor for death. […] Metabolic acidosis is strongly associated with an increased risk of death. […] Prognosis has been shown to be worse in patients whose lactate levels do not normalize within a few hours of admission and the levels of lactate in fatal cases were nearly double those of survivors.

• #10 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Respiratory distress describes abnormal, deep and effortful breathing with an increased respiratory rate for age. […] It is present in over half of reported malarial deaths. […] Renal dysfunction associated with malaria is due to acute tubular necrosis and less commonly interstitial nephritis and glomerulonephritis; multiple mechanisms including parasitized erythrocytes causing tissue hypoperfusion and immune complex deposition have been proposed. […] The presence of acute renal impairment has not only been shown to be a risk factor for the development of chronic kidney disease but also for long-term neurological impairment in CM. […] Thrombocytopenia is defined as platelet levels lower than expected for age. […] Several studies have reported its usefulness in aiding malaria diagnosis and as a predictor of mortality but have varying results due to their different definitions of thrombocytopenia.

• #11 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Respiratory distress describes abnormal, deep and effortful breathing with an increased respiratory rate for age. […] It is present in over half of reported malarial deaths. […] Renal dysfunction associated with malaria is due to acute tubular necrosis and less commonly interstitial nephritis and glomerulonephritis; multiple mechanisms including parasitized erythrocytes causing tissue hypoperfusion and immune complex deposition have been proposed. […] The presence of acute renal impairment has not only been shown to be a risk factor for the development of chronic kidney disease but also for long-term neurological impairment in CM. […] Thrombocytopenia is defined as platelet levels lower than expected for age. […] Several studies have reported its usefulness in aiding malaria diagnosis and as a predictor of mortality but have varying results due to their different definitions of thrombocytopenia.

• #12 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  Respiratory distress describes abnormal, deep and effortful breathing with an increased respiratory rate for age. […] It is present in over half of reported malarial deaths. […] Renal dysfunction associated with malaria is due to acute tubular necrosis and less commonly interstitial nephritis and glomerulonephritis; multiple mechanisms including parasitized erythrocytes causing tissue hypoperfusion and immune complex deposition have been proposed. […] The presence of acute renal impairment has not only been shown to be a risk factor for the development of chronic kidney disease but also for long-term neurological impairment in CM. […] Thrombocytopenia is defined as platelet levels lower than expected for age. […] Several studies have reported its usefulness in aiding malaria diagnosis and as a predictor of mortality but have varying results due to their different definitions of thrombocytopenia.

• #13 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  SMA is a major cause of hospitalization and is associated with poor prognosis and increased mortality. […] If SMA is accompanied by another clinical syndrome, particularly respiratory distress, the mortality rates are much higher. […] In childhood malaria, respiratory distress is largely attributed to metabolic acidosis and is less commonly due to parenchymal lung disease or heart failure related to anemia. […] When appropriate tests are available, metabolic acidosis has consistently been identified as an independent predictor of mortality. […] It is clear that prognostic factors and biomarkers specific for distinct SM syndromes also hold promise, and may result in better prediction of adverse outcomes than general prognostic markers in SM. […] This approach to prognosis appears most promising in CM, and additional work is needed to identify and validate syndrome-specific biomarkers in SMA and respiratory distress.

• #14 Prognostic models for the clinical management of malaria and its complications: a systematic review – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31772089/

  Objective: Malaria infection could result in severe disease with high mortality. Prognostic models and scores predicting severity of infection, complications and mortality could help clinicians prioritise patients. […] Conclusion: Evidence is lacking on the generalisability of most of these models due lack of external validation. Emphasis should be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

• #15 (PDF) A Simple Score to Predict the Outcome of Severe Malaria in Adults

  https://www.academia.edu/24118494/A_Simple_Score_to_Predict_the_Outcome_of_Severe_Malaria_in_Adults

  World Health Organization guidelines advocate for adult patients with severe malaria to be admitted to intensive care units (ICUs). […] A logistic regression model was developed using data from a trial in Southeast Asia, identifying acidosis and consciousness level as key predictors of mortality. The resulting 5-point Coma Acidosis Malaria (CAM) score predicts patient outcomes effectively, allowing for safer treatment in general wards for those with low scores, which suggests practical applications for improved patient management in limited-resource settings. […] The Sequential Organ Failure Assessment (SOFA) score was used to monitor organ dysfunctions. […] In conclusion, the SOFA score was readily applicable and efficient in monitoring daily organ dysfunction but was not effective enough in predicting the outcome of severe malaria patients.

• #16 (PDF) A Simple Score to Predict the Outcome of Severe Malaria in Adults

  https://www.academia.edu/24118494/A_Simple_Score_to_Predict_the_Outcome_of_Severe_Malaria_in_Adults

  World Health Organization guidelines advocate for adult patients with severe malaria to be admitted to intensive care units (ICUs). […] A logistic regression model was developed using data from a trial in Southeast Asia, identifying acidosis and consciousness level as key predictors of mortality. The resulting 5-point Coma Acidosis Malaria (CAM) score predicts patient outcomes effectively, allowing for safer treatment in general wards for those with low scores, which suggests practical applications for improved patient management in limited-resource settings. […] The Sequential Organ Failure Assessment (SOFA) score was used to monitor organ dysfunctions. […] In conclusion, the SOFA score was readily applicable and efficient in monitoring daily organ dysfunction but was not effective enough in predicting the outcome of severe malaria patients.

• #17 (PDF) A Simple Score to Predict the Outcome of Severe Malaria in Adults

  https://www.academia.edu/24118494/A_Simple_Score_to_Predict_the_Outcome_of_Severe_Malaria_in_Adults

  An early and accurate assessment of the severity score is essential for the management of severe malaria patients. […] The aim of this paper was to devise a simple and reliable malaria prognosis score (MPS) to predict the outcome of adults with severe malaria. […] Hyponatremia has been found as a complication in severe malaria. […] The aim of this study is to determine the prevalence of hyponatremia in severe malaria and its association with mortality in a referral hospital. […] The Lambare ne Organ Dysfunction Score (LODS) combines 3 variables: coma, prostration, and deep breathing. […] A LODS 10 (odd ratio, 9.6; 95% confidence interval, 8.0-11.4) has 85% sensitivity to predict death, and a LODS !3 is highly (98%) specific for survival. […] SOFA score may be useful to discriminate severe disease and mortality in patients with P. falciparum malaria.

• #18 (PDF) A Simple Score to Predict the Outcome of Severe Malaria in Adults

  https://www.academia.edu/24118494/A_Simple_Score_to_Predict_the_Outcome_of_Severe_Malaria_in_Adults

  An early and accurate assessment of the severity score is essential for the management of severe malaria patients. […] The aim of this paper was to devise a simple and reliable malaria prognosis score (MPS) to predict the outcome of adults with severe malaria. […] Hyponatremia has been found as a complication in severe malaria. […] The aim of this study is to determine the prevalence of hyponatremia in severe malaria and its association with mortality in a referral hospital. […] The Lambare ne Organ Dysfunction Score (LODS) combines 3 variables: coma, prostration, and deep breathing. […] A LODS 10 (odd ratio, 9.6; 95% confidence interval, 8.0-11.4) has 85% sensitivity to predict death, and a LODS !3 is highly (98%) specific for survival. […] SOFA score may be useful to discriminate severe disease and mortality in patients with P. falciparum malaria.

• #19 Navigating mortality prediction in severe malaria: risk stratification models from the emergency department of coastal India | Chaudhary | Disaster and Emergency Medicine Journal

  https://journals.viamedica.pl/disaster_and_emergency_medicine/article/view/100606

  Malaria, a pervasive infectious disease, remains a critical health concern worldwide, particularly in regions with high transmission rates. This study investigates demographic patterns and prognostic factors influencing outcomes in malaria patients presenting to the emergency department (ED). […] Mortality predictors were assessed in malaria-positive patients, including Shock Index (SI), Modified Early Warning Score (MEWS), Sequential Organ Failure Assessment (SOFA), Malaria Severity Index (MSA), Malaria Prognostic Score (MPS), Coma Acidosis Malaria (CAM) score, Respiratory and Bicarbonate-based CAM score (R-CAM and B-CAM), Glasgow Coma Scale (GCS), and GCRBS Score. […] Analysis of 114 severe malaria cases revealed higher mortality (21.1%) among older rural patients. Non-survivors exhibited elevated pulse rates (139.83 7.43), lower blood pressure (systolic: 62.58 28.27, diastolic: 47.33 20.73), and impaired consciousness (GCS: 6.63 1.69). GCRBS, MSA, and SOFA scores demonstrated exceptional predictive accuracy (AUC = 1.00).

• #20 Navigating mortality prediction in severe malaria: risk stratification models from the emergency department of coastal India | Chaudhary | Disaster and Emergency Medicine Journal

  https://journals.viamedica.pl/disaster_and_emergency_medicine/article/view/100606

  Identifying crucial mortality predictors like MSA, MPS, CAM, and GCRBS scores in malaria patients can optimize ED management protocols effectively. […] Prognosticating the outcomes of malaria patients relies heavily on a combination of clinical and laboratory features, aiding in swift triaging and identifying those needing urgent critical care admission. […] In severe malaria cases, non-survivors showed significantly higher frequencies of Glasgow Coma Scale (GCS) scores 10 (100%), seizures (16.7%), haemoglobin levels 5 g/dL (98.2%), elevated total bilirubin (100%), and creatinine levels 3 mg/dL (91.7% vs 6.7%) compared to survivors. […] In assessing the accuracy of mortality predictors, the area under the ROC curve was utilized. Among them, the GCRBS score stood out with remarkable performance metrics. It demonstrated perfect sensitivity (100%) and specificity (100%), accompanied by an impressive Area under the curve (AUC) of 1.00. Similarly, the MSA and SOFA scores showed outstanding predictive accuracy, with sensitivity and specificity both at 100% and AUCs of 1.00. […] The integration of these predictive markers into routine ED practices holds the potential to standardize protocols, particularly in regions burdened by malaria.

• #21 Navigating mortality prediction in severe malaria: risk stratification models from the emergency department of coastal India | Chaudhary | Disaster and Emergency Medicine Journal

  https://journals.viamedica.pl/disaster_and_emergency_medicine/article/view/100606

  Identifying crucial mortality predictors like MSA, MPS, CAM, and GCRBS scores in malaria patients can optimize ED management protocols effectively. […] Prognosticating the outcomes of malaria patients relies heavily on a combination of clinical and laboratory features, aiding in swift triaging and identifying those needing urgent critical care admission. […] In severe malaria cases, non-survivors showed significantly higher frequencies of Glasgow Coma Scale (GCS) scores 10 (100%), seizures (16.7%), haemoglobin levels 5 g/dL (98.2%), elevated total bilirubin (100%), and creatinine levels 3 mg/dL (91.7% vs 6.7%) compared to survivors. […] In assessing the accuracy of mortality predictors, the area under the ROC curve was utilized. Among them, the GCRBS score stood out with remarkable performance metrics. It demonstrated perfect sensitivity (100%) and specificity (100%), accompanied by an impressive Area under the curve (AUC) of 1.00. Similarly, the MSA and SOFA scores showed outstanding predictive accuracy, with sensitivity and specificity both at 100% and AUCs of 1.00. […] The integration of these predictive markers into routine ED practices holds the potential to standardize protocols, particularly in regions burdened by malaria.

• #22 Predictors of treatment failures of plasmodium falciparum malaria in Vietnam: a 4-year single‐centre retrospective study | Malaria Journal | Full Text

  https://malariajournal.biomedcentral.com/articles/10.1186/s12936-021-03720-3

  Drug-resistant falciparum malaria is an increasing public health burden. This study examined the magnitude of Plasmodium falciparum infection and the patterns and predictors of treatment failure in Vietnam. More than half (59.8%, 265/443, CI 55.164.4%) of patients acquired Plasmodium falciparum infection of whom 21.9% (58/265, CI 17.127.4%) had severe malaria, while 7.2% (19/265, CI 4.610.9%) and 19.2% (51/265, CI 14.724.5%) developed early treatment failure (ETF) and late treatment failure (LTF) respectively. Severe malaria was statistically associated with receiving treatment at previous hospitals (P0.001), hepatomegaly (P0.001) and number of inpatient days (P0.001). Having severe malaria was a predictor of ETF (AOR 6.96, CI 2.5519.02, P0.001). No predictor of LTF was identified. Plasmodium falciparum remains the prevalent malaria parasite. Despite low mortality rate, severe malaria is not rare and is a significant predictor of ETF. To reduce the risk for ETF, studies are needed to examine the effectiveness of combination therapy including parenteral artesunate and a parenteral partner drug for severe malaria.

• #23 Predictors of treatment failures of plasmodium falciparum malaria in Vietnam: a 4-year single‐centre retrospective study | Malaria Journal | Full Text

  https://malariajournal.biomedcentral.com/articles/10.1186/s12936-021-03720-3

  The presence of ETF among study participants was examined based on the clinical symptoms and laboratory tests. […] Patients with severe malaria were significantly more likely to develop ETF (P0.001, OR 7.5, CI 2.820.0) and less likely to develop LTF (P=0.044, OR 0.44, CI 0.190.99) compared with those who did not have severe malaria. […] No predictor for ETF was identified other than having severe malaria (AOR 6.96, CI 2.5519.02, P0.001). No predictor for LTF was identified.

• #24 The usefulness of twenty-four molecular markers in predicting treatment outcome with combination therapy of amodiaquine plus sulphadoxine-pyrimethamine against falciparum malaria in Papua New Guinea | springermedizin.de

  https://www.springermedizin.de/the-usefulness-of-twenty-four-molecular-markers-in-predicting-tr/9548226

  In 2004, Day-28 treatment failure rates for AQ+SP were 29% in the Karimui and 19% in the South Wosera area, respectively. The strongest independent predictors for treatment failure with AQ+SP were pfmdr1 N86Y (OR = 7.87, p 0.01) and pfdhps A437G (OR = 3.44, p 0.01). […] The study provides evidence for high levels of resistance to the combination regimen of AQ+SP in PNG and indicates which of the many molecular markers analysed are useful for the monitoring of parasite resistance to combinations with AQ+SP. […] The only single marker associated with a significantly increased risk of treatment failure was pfmdr1 N86Y. […] Risk of failure was only increased with infections harbouring the A437G mutation in pfdhps. […] The risk was significantly increased for patients harbouring parasites with the most highly mutated genotype (i.e., 8/24 SNPs mutated).

• #25 Serum Angiopoietin-1 and -2 Levels Discriminate Cerebral Malaria from Uncomplicated Malaria and Predict Clinical Outcome in African Children | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004912

  Limited tools exist to identify which individuals infected with Plasmodium falciparum are at risk of developing serious complications such as cerebral malaria (CM). […] The objective of this study was to assess serum biomarkers that differentiate between CM and non-CM, with the long-term goal of developing a clinically informative prognostic test for severe malaria. […] Moreover, low ANG-1 levels at presentation predicted subsequent mortality in children with CM (p=0.027). […] ANG-1 and the ANG-2/1 ratio are promising clinically informative biomarkers for CM. Additional studies should address their utility as prognostic biomarkers and potential therapeutic targets in severe malaria. […] The manifestations and outcomes of severe and CM may differ between adults and children and between varying genetic backgrounds of patient and parasite populations.

• #26 Serum Angiopoietin-1 and -2 Levels Discriminate Cerebral Malaria from Uncomplicated Malaria and Predict Clinical Outcome in African Children | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004912

  Our findings are in agreement with a recent study by Yeo et al. who reported that ANG-2 levels were higher in Indonesian adults with severe malaria and were better predictors of death than other markers of disease, such as lactate. […] Our observations that ANG-1 and ANG-2 are dysregulated in patients with CM, supports the hypothesis that they may be involved in the pathogenesis of this syndrome. […] These data suggest that the dysregulation of angiogenic factors may be involved in the pathogenesis of cerebral malaria and that serum ANG-1 and ANG-2 levels are accurate biomarkers to discriminate CM from uncomplicated disease and predict survival in African children with cerebral involvement.

• #27 Modeling the dynamics of Plasmodium falciparum gametocytes in humans during malaria infection | eLife

  https://elifesciences.org/articles/49058

  Renewed efforts to eliminate malaria have highlighted the potential to interrupt human-to-mosquito transmission a process mediated by gametocyte kinetics in human hosts. […] We found that the model provides an excellent fit to the clinical data from 17 volunteers infected with P. falciparum (3D7 strain) and reliably predicts observed gametocytemia. […] An accurate understanding of the kinetics of gametocyte development in the human host is essential to predict the probability of transmission. […] The sexual commitment rate the percentage of asexual parasites entering sexual development during each asexual replication cycle is estimated to be 0.54%/asexual replication cycle (95% credible interval (CI): 0.301.00%). […] The gametocyte sequestration time is the average time that immature gametocytes (stages IIV) cannot be observed in the peripheral circulation.

• #28 Modeling the dynamics of Plasmodium falciparum gametocytes in humans during malaria infection | eLife

  https://elifesciences.org/articles/49058

  We predicted the effects of altered gametocyte kinetic parameters on the transmissibility from humans to mosquitoes, focusing on two scenarios: the infectiousness of newly hospitalized clinical malaria cases and the non-infectious period of malaria patients. […] A higher sexual commitment rate or a lower gametocyte sequestration time leads to a higher gametocytemia at the time of hospitalization. […] The model provides a powerful predictive tool for informing the design of future volunteer infection studies which aim to test transmission-blocking interventions.

• #29 Mortality Patterns and Site Heterogeneity of Severe Malaria in African Children | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0058686

  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. […] Overall mortality was 43% (N=1,129). […] Combining all sites, deep breathing, prostration and hypoglycemia were independent predictors for early, intermediate and late mortality (P001). […] Site heterogeneity for mortality prediction is evident in African children with severe malaria. Prediction for early mortality has the highest consistency between sites. […] The most consistent predictive model included 3 admission variables, namely deep breathing, prostration and coma for death within 24 hours. Predictive models for intermediate and late mortality were highly variable between sites. […] Multivariate analysis predicting early, intermediate and late mortality at all sites were prostration, deep breathing and hypoglycaemia. This finding underlines the importance of neurologic manifestations of P. falciparum related mortality. […] We observed a large variability of predictors for intermediate and late mortality between sites.

• #30 Mortality Patterns and Site Heterogeneity of Severe Malaria in African Children | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0058686

  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. […] Overall mortality was 43% (N=1,129). […] Combining all sites, deep breathing, prostration and hypoglycemia were independent predictors for early, intermediate and late mortality (P001). […] Site heterogeneity for mortality prediction is evident in African children with severe malaria. Prediction for early mortality has the highest consistency between sites. […] The most consistent predictive model included 3 admission variables, namely deep breathing, prostration and coma for death within 24 hours. Predictive models for intermediate and late mortality were highly variable between sites. […] Multivariate analysis predicting early, intermediate and late mortality at all sites were prostration, deep breathing and hypoglycaemia. This finding underlines the importance of neurologic manifestations of P. falciparum related mortality. […] We observed a large variability of predictors for intermediate and late mortality between sites.

• #31 Prognostic models for the clinical management of malaria and its complications: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/11/e030793

  Objective Malaria infection could result in severe disease with high mortality. Prognostic models and scores predicting severity of infection, complications and mortality could help clinicians prioritise patients. […] A total of 564 articles were screened and 24 articles were retained which described 27 models/scores of interests. […] For the models predicting mortality, all the models had neurological dysfunction as a predictor; in children, half of the models contained hypoglycaemia and respiratory failure as a predictor meanwhile, six out of the nine models in adults had respiratory failure as a clinical predictor. […] Evidence is lacking on the generalisability of most of these models due lack of external validation. Emphasis should be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

• #32 Prognostic models for the clinical management of malaria and its complications: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/11/e030793

  The models identified in this review that were used to predict mortality in children with severe malaria have similar clinical predictors. All the models had neurological dysfunction based on either the Glasgow coma score, impaired consciousness, altered mental status, convulsions, decerabration or coma as a predictor. Similarly, in adults, all the models predicting mortality also had neurological dysfunction as a predictor. […] Factors that were predictive of disease severity and mortality seemed to be consistent among these studies. The factors that should therefore be considered by physicians when faced with a patient with malaria infection should include: neurological dysfunction (coma and seizures), acidosis, hypoglycaemia and respiratory distress. […] Models predicting severity and mortality of malaria infection identified in this review have similar predictors. Evidence is, however, lacking on the generalisability of most of these models due lack of external validation. Emphasis should therefore be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

• #33 Prognostic models for the clinical management of malaria and its complications: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/11/e030793

  The models identified in this review that were used to predict mortality in children with severe malaria have similar clinical predictors. All the models had neurological dysfunction based on either the Glasgow coma score, impaired consciousness, altered mental status, convulsions, decerabration or coma as a predictor. Similarly, in adults, all the models predicting mortality also had neurological dysfunction as a predictor. […] Factors that were predictive of disease severity and mortality seemed to be consistent among these studies. The factors that should therefore be considered by physicians when faced with a patient with malaria infection should include: neurological dysfunction (coma and seizures), acidosis, hypoglycaemia and respiratory distress. […] Models predicting severity and mortality of malaria infection identified in this review have similar predictors. Evidence is, however, lacking on the generalisability of most of these models due lack of external validation. Emphasis should therefore be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

• #34 Key factors predicting suspected severe malaria case management and health outcomes: an operational study in the Democratic Republic of the Congo | springermedizin.de

  https://www.springermedizin.de/key-factors-predicting-suspected-severe-malaria-case-management-/23544246

  Evidence suggests that pre-referral Rectal Artesunate (RAS) can be a life-saving intervention for severe malaria in remote settings in Africa. Recognition of danger signs indicative of severe malaria is critical for prompt and appropriate case management. […] The main findings point towards the fact that danger signs are reasonably well recognized by health provider at the primary care level, and that RAS could influence positively health outcomes of such severe disease episodes and death. Its effectiveness is hampered by the insufficient quality of care at RHF, especially the provision of a full course of ACT following parenteral treatment. These are simple but important findings that requires urgent action by the health system planners and implementers. […] The results presented here are part of the Community Access to Rectal Artesunate for Malaria (CARAMAL) project carried out in the DR Congo, Nigeria and Uganda to assess the case management for SM in remote locations and assess the public health value of RAS as a pre-referral treatment under real-world conditions.

• #35 Key factors predicting suspected severe malaria case management and health outcomes: an operational study in the Democratic Republic of the Congo | springermedizin.de

  https://www.springermedizin.de/key-factors-predicting-suspected-severe-malaria-case-management-/23544246

  The odds of dying were 1.50 times higher in patients who did not receive RAS, although the difference was on the margins of statistical significance. DRC key findings are consistent with findings in Nigeria and Uganda, and point towards the fact that RAS can work in reducing mortality, but it does not work well as a single intervention. RAS can only become effective in the frame of a functioning health systems that includes a functioning referral system, and especially an improved quality of case management in RHFs.

• #36 Advances in mapping malaria for elimination: fine resolution modelling of Plasmodium falciparum incidence | Scientific Reports

  https://www.nature.com/articles/srep29628

  The long-term goal of the global effort to tackle malaria is national and regional elimination and eventually eradication. […] Here, we show how malaria incidence can be modelled at a fine spatial and temporal resolution from health facility data to help focus surveillance and control to population not attending health facilities. […] We then combined the incidence estimates with population maps to estimate clinical burdens and show the benefits of such mapping to identifying areas and seasons that can be targeted for improved surveillance and interventions. […] The main goal was the prediction of a time-series of monthly malaria incidence at a fine spatial resolution with complete coverage based on incidence measured at health facilities. […] The fine spatial resolution prediction should help pre-elimination programmes to allocate resources effectively to the population most in need, maximising public health impact.

• #37 Advances in mapping malaria for elimination: fine resolution modelling of Plasmodium falciparum incidence | Scientific Reports

  https://www.nature.com/articles/srep29628

  Here, we demonstrated a method for predicting incidence at a fine spatial resolution for operational purposes in malaria elimination. […] Mapping incidence at a fine spatial and temporal resolution improves clinical burden estimates and can be used to target resources to specific local populations. […] The effect of population movements within country and internationally with neighbouring countries remains to be investigated as part of future research.

• #38 Prognostic models for the clinical management of malaria and its complications: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/11/e030793

  The models identified in this review that were used to predict mortality in children with severe malaria have similar clinical predictors. All the models had neurological dysfunction based on either the Glasgow coma score, impaired consciousness, altered mental status, convulsions, decerabration or coma as a predictor. Similarly, in adults, all the models predicting mortality also had neurological dysfunction as a predictor. […] Factors that were predictive of disease severity and mortality seemed to be consistent among these studies. The factors that should therefore be considered by physicians when faced with a patient with malaria infection should include: neurological dysfunction (coma and seizures), acidosis, hypoglycaemia and respiratory distress. […] Models predicting severity and mortality of malaria infection identified in this review have similar predictors. Evidence is, however, lacking on the generalisability of most of these models due lack of external validation. Emphasis should therefore be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

• #39 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  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 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.

• #40 Predictors of outcome in childhood Plasmodium falciparum malaria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7051137/

  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 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.

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