title: Predictive score of uncomplicated falciparum malaria patients turning to severe malaria.
abstract: In acute uncomplicated falciparum malaria, there is a continuum from mild to severe malaria. However, no mathematical system is available to predict uncomplicated falciparum malaria patients turning to severe malaria. This study aimed to devise a simple and reliable model of Malaria Severity Prognostic Score (MSPS). The study was performed in adult patients with acute uncomplicated falciparum malaria admitted to the Bangkok Hospital for Tropical Diseases between 2000 and 2005. Total 38 initial clinical parameters were identified to predict the usual recovery or deterioration to severe malaria. The stepwise multiple discriminant analysis was performed to get a linear discriminant equation. The results showed that 4.3% of study patients turned to severe malaria. The MSPS = 4.38 (schizontemia) + 1.62 (gametocytemia) + 1.17 (dehydration) + 0.14 (overweight by body mass index; BMI) + 0.05 (initial pulse rate) + 0.04 (duration of fever before admission) - 0.50 (past history of malaria in last 1 year) - 0.48 (initial serum albumin) - 5.66. Based on the validation study in other malaria patients, the sensitivity and specificity were 88.8% and 88.4%, respectively. We conclude that the MSPS is a simple screening tool for predicting uncomplicated falciparum malaria patients turning to severe malaria. However, the MSPS may need revalidation in different geographical areas before utilized at specific places.
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Noppadon
authors.initials: N
authors.lastname: Tangpukdee
authors.forename: Srivicha
authors.initials: S
authors.lastname: Krudsood
authors.forename: Vipa
authors.initials: V
authors.lastname: Thanachartwet
authors.forename: Chatnapa
authors.initials: C
authors.lastname: Duangdee
authors.forename: Siriphan
authors.initials: S
authors.lastname: Paksala
authors.forename: Putza
authors.initials: P
authors.lastname: Chonsawat
authors.forename: Siripan
authors.initials: S
authors.lastname: Srivilairit
authors.forename: Sornchai
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: Polrat
authors.initials: P
authors.lastname: Wilairatana
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D018450:Disease Progression; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013785:Thailand; D016896:Treatment Outcome