{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:39:24Z","timestamp":1777426764491,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,12,4]],"date-time":"2009-12-04T00:00:00Z","timestamp":1259884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Objectives\u2002<\/jats:bold> Hypoglycaemia (glucose &lt;2.2\u2003mmol\/l) is a defining feature of severe malaria, but the significance of other levels of blood glucose has not previously been studied in children with severe malaria.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> A prospective study of 437 consecutive children with presumed severe malaria was conducted in Mali. We defined hypoglycaemia as &lt;2.2\u2003mmol\/l, low glycaemia as 2.2\u20134.4\u2003mmol\/l and hyperglycaemia as &gt;8.3\u2003mmol\/l. Associations between glycaemia and case fatality were analysed for 418 children using logistic regression models and a receiver operator curve (ROC).<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> There was a significant difference between blood glucose levels in children who died (median 4.6\u2003mmol\/l) and survivors (median 7.6\u2003mmol\/l, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). Case fatality declined from 61.5% of the hypoglycaemic children to 46.2% of those with low glycaemia, 13.4% of those with normal glycaemia and 7.6% of those with hyperglycaemia (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). Logistic regression showed an adjusted odds ratio (AOR) of 0.75 (0.64\u20130.88) for case fatality per 1\u2003mmol\/l increase in baseline blood glucose. Compared to a normal blood glucose, hypoglycaemia and low glycaemia both significantly increased the odds of death (AOR 11.87, 2.10\u201367.00; and 5.21, 1.86\u201314.63, respectively), whereas hyperglycaemia reduced the odds of death (AOR 0.34, 0.13\u20130.91). The ROC [area under the curve at 0.753 (95% CI 0.684\u20130.820)] indicated that glycaemia had a moderate predictive value for death and identified an optimal threshold at glycaemia &lt;6.1\u2003mmol\/l, (sensitivity 64.5% and specificity 75.1%).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> If there is a threshold of blood glucose which defines a worse prognosis, it is at a higher level than the current definition of 2.2\u2003mmol\/l.<\/jats:p>","DOI":"10.1111\/j.1365-3156.2009.02444.x","type":"journal-article","created":{"date-parts":[[2009,12,4]],"date-time":"2009-12-04T09:20:59Z","timestamp":1259918459000},"page":"232-240","source":"Crossref","is-referenced-by-count":34,"title":["Blood glucose and prognosis in children with presumed severe malaria: is there a threshold for \u2018hypoglycaemia\u2019?"],"prefix":"10.1111","volume":"15","author":[{"given":"Merlin L.","family":"Willcox","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"Forster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moussa I.","family":"Dicko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertrand","family":"Graz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Mayon\u2010White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert","family":"Barennes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,1,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-2218"},{"key":"e_1_2_7_3_1","volume-title":"Am\u00e9lioration de la prise en charge du paludisme grave dans le Service de Pediatrie de l\u2019Hopital Regional de Sikasso","author":"Dicko M","year":"2008"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-7-242"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02752447"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(94)90504-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505253322102"},{"key":"e_1_2_7_8_1","volume-title":"Principles of Medicine in Africa","author":"Parry E","year":"2004"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/377536"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1999.61.431"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810203191602"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-3171"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2001.tb02422.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)90354-0"},{"key":"e_1_2_7_15_1","volume-title":"Management of the Child with a Serious Infection or Severe Malnutrition","author":"WHO","year":"2000"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(00)90300-6"},{"key":"e_1_2_7_17_1","volume-title":"Vade\u2010mecum pour la prise en charge du paludisme grave","author":"WHO","year":"2001"},{"key":"e_1_2_7_18_1","volume-title":"Guidelines for the Treatment of Malaria","author":"WHO","year":"2006"},{"key":"e_1_2_7_19_1","volume-title":"WHO Child Growth Standards: Length\/Height\u2010for\u2010age, Weight\u2010for\u2010Age, Weight\u2010for\u2010Length, Weight\u2010for\u2010Height and Body Mass Index\u2010for\u2010Age: Methods and Development","author":"WHO","year":"2006"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2008.02064.x"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-3156.2009.02444.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-3156.2009.02444.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T04:25:54Z","timestamp":1697257554000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-3156.2009.02444.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,1,12]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,2]]}},"alternative-id":["10.1111\/j.1365-3156.2009.02444.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-3156.2009.02444.x","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,1,12]]}}}