title: The Lambaréné Organ Dysfunction Score (LODS) is a simple clinical predictor of fatal malaria in African children.
abstract: BACKGROUND
  Plasmodium falciparum malaria accounts for >1 million deaths annually, mostly among young children in sub-Saharan Africa. Identifying those individuals who are likely to die is crucial. Several factors have been independently associated with death. Because malaria is a systemic disease, a quantitative score combining such risk factors may be superior.
  
  
  METHODS
  We used both forward and backward stepwise logistic regression to select the best predictors of death, as evaluated for 23,890 African children with severe P. falciparum malaria. The study was conducted from December 2000 through May 2005 in 6 hospital-based research units (in Banjul in the Gambia, Blantyre in Malawi, Kilifi in Kenya, Kumasi in Ghana, and Lambaréné and Libreville in Gabon) in a network established to study severe malaria in African children (ie, the SMAC Network).
  
  
  RESULTS
  The Lambaréné Organ Dysfunction Score (LODS) combines 3 variables: coma, prostration, and deep breathing. A LODS >0 (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.
  
  
  CONCLUSIONS
  The LODS is a simple clinical predictor of fatal malaria in African children. This score provides accurate and rapid identification of children needing either referral or increased attention.
authors.affiliation: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. raimund.helbok@uki.at
authors.forename: Raimund
authors.initials: R
authors.lastname: Helbok
authors.forename: Eric
authors.initials: E
authors.lastname: Kendjo
authors.forename: Saadou
authors.initials: S
authors.lastname: Issifou
authors.forename: Peter
authors.initials: P
authors.lastname: Lackner
authors.forename: Charles R
authors.initials: CR
authors.lastname: Newton
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Kombila
authors.forename: Tsiri
authors.initials: T
authors.lastname: Agbenyega
authors.forename: Kalifa
authors.initials: K
authors.lastname: Bojang
authors.forename: Klaus
authors.initials: K
authors.lastname: Dietz
authors.forename: Erich
authors.initials: E
authors.lastname: Schmutzhard
authors.forename: Peter Gottfried
authors.initials: PG
authors.lastname: Kremsner
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D005681:Gabon; D005714:Gambia; D005869:Ghana; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D008295:Malawi; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011379:Prognosis; D012720:Severity of Illness Index