title: Physiopathologic factors resulting in poor outcome in childhood severe malaria in Cameroon.
abstract: OBJECTIVE
  We evaluated plasma creatinine, urea, bilirubin, lactic acid, and nitric oxide values in children with malaria to identify indices of disease severity and predictors of fatal outcomes.
  
  
  METHODS
  Children 0 to 15 years old were recruited, clinical data recorded, and blood samples collected. Plasma creatinine, urea, bilirubin, lactic acid, and nitric oxide (NO) values were determined by spectrophotometry.
  
  
  RESULTS
  Values of creatinine, urea, and bilirubin were normal in all the groups except for urea in some groups (55.30 +/- 5.508 mg/dL and 60.45 +/- 15.56 mg/dL in anemia patients and those with the combined symptoms of cerebral malaria and anemia, respectively). The mean lactate values were high in severe malaria groups (0.57 +/- 0.05 g/L and 0.48 +/- 0.05 g/L in cerebral malaria and anemia patients, respectively). As for the mean NO values, they were above the normal range in all the groups, except the controls, but particularly in the severe malaria groups (68.66 +/- 7.85, 84.52 +/- 8.17, 99.57 +/- 10.48, 87.25 +/- 12.57, and 93.48 +/- 7.09 micromol/L for the control, uncomplicated malaria, anemia, cerebral malaria patients and those with the combined symptoms of cerebral malaria and anemia, respectively; P = 0.643).
  
  
  CONCLUSIONS
  In this setting, lactate and NO were indicators of poor prognosis. Though the impact of creatinine, urea, and bilirubin were not found to be significant, they can still be useful to assess improvement in severe malaria cases.
authors.affiliation: Department of Biochemistry, University of Douala, Douala, Cameroon. gouadoi@yahoo.fr
authors.forename: Inocent
authors.initials: I
authors.lastname: Gouado
authors.forename: Joël Bertrand
authors.initials: JB
authors.lastname: Pankoui M
authors.forename: Honoré
authors.initials: H
authors.lastname: Fotso K
authors.forename: Odette
authors.initials: O
authors.lastname: Zambou
authors.forename: Salomé
authors.initials: S
authors.lastname: Nguélé
authors.forename: Valéry
authors.initials: V
authors.lastname: Combes
authors.forename: Georges E
authors.initials: GE
authors.lastname: Grau
authors.forename: Paul Henri
authors.initials: PH
authors.lastname: Amvam Z
mesh_terms: D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002163:Cameroon; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019344:Lactic Acid / Q000097:blood; D008288:Malaria / Q000097:blood*; D016779:Malaria, Cerebral / Q000097:blood; D008297:Male; D009569:Nitric Oxide / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013053:Spectrophotometry; D018709:Statistics, Nonparametric; D014508:Urea / Q000097:blood
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide; D019344:Lactic Acid; D014508:Urea; D003404:Creatinine; D001663:Bilirubin