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Severe imported Plasmodium falciparum malaria in children: characteristics and useful factors in the risk

Agnese Comelli1, María Espiau Guarner2, Lina Rachele Tomasoni1

  • 1University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Travel Medicine and Infectious Disease
|November 8, 2021
PubMed

Insights

A new scoring model using age, white blood cells (WBC), and C-reactive protein can identify children at high risk for severe imported malaria in non-endemic areas.

Area of Science:

  • Pediatric Infectious Diseases
  • Tropical Medicine
  • Clinical Epidemiology

Background:

  • Severe imported pediatric malaria poses a significant challenge in non-endemic regions.
  • Accurate risk stratification of pediatric severe malaria cases is crucial for timely intervention.

Purpose of the Study:

  • To identify key features of severe pediatric malaria cases.
  • To develop a predictive model for stratifying patient risk upon presentation.

Main Methods:

  • Retrospective cross-sectional study of imported P. falciparum malaria in children (≤14 years) from 2008-2019.
  • Analysis of adverse outcomes including mortality, PICU admission, and blood transfusion.
  • Development and evaluation of a predictive model using clinical and laboratory parameters.

Main Results:

  • 30.9% of pediatric malaria cases were classified as severe.
  • Predictors for severe malaria included young age, low hemoglobin, elevated white blood cells (WBC), and high C-reactive protein.
  • A model incorporating age, WBC, and C-reactive protein demonstrated high specificity (92.3%) for identifying non-severe cases.

Conclusions:

  • A simple scoring system based on age, WBC, and C-reactive protein can effectively identify children at higher risk of adverse outcomes.
  • This score is easily applicable in emergency room settings for rapid risk assessment.
  • The model aids in early detection and management of severe pediatric malaria.
Abstract

Keywords:
Imported diseasesPediatric infectionSevere malaria

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