{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:23:47Z","timestamp":1761513827779},"reference-count":28,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The World Health Organization (WHO) severity criteria for paediatric <jats:italic>Plasmodium falciparum<\/jats:italic> (Pf) malaria are based on studies in countries of endemic malaria. The relevance of these criteria for other countries remains unclear. We assessed the relevance of these criteria in an industrialised country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective case-control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Eight French university hospitals, from 2006 to 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Children with Pf malaria admitted to paediatric intensive care units (cases: n=55) or paediatric emergency departments (controls: n=110).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Descriptive analysis of WHO severity criteria and major interventions (mechanical ventilation, blood transfusion, fluid challenge, treatment of cerebral oedema, renal replacement therapy). Thresholds were set by receiver operating characteristics curve analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altered consciousness (71% vs 5%), shock (24% vs 1%), renal failure (20% vs 1%), anaemia &lt;50\u2005g\/L (7% vs 2%), acidosis (38% vs 0%), bilirubin level &gt;50\u2005\u00b5mol\/L (25% vs 8%) and parasitaemia &gt;10% (30% vs 8%) were more frequent in cases (p&lt;0.01). All these criteria were associated with major interventions (p&lt;0.001). Respiratory distress (six cases), and hypoglycaemia (two cases) were infrequent. Thrombocytopenia &lt;50\u2005000\/mm<jats:sup>3<\/jats:sup> (46% vs 7%) and anaemia (haemoglobin concentration &lt;70\u2005g\/L (41% vs 13%)) were more frequent in cases (p&lt;0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The WHO severity criteria for paediatric Pf malaria are relevant for countries without endemic malaria. The infrequent but severe complications also provide a timely reminder of the morbidity and mortality associated with this condition worldwide. In non-endemic countries haemoglobin &lt;70\u2005g\/L and platelet count &lt;50\u2005000\/mm<jats:sup>3<\/jats:sup> could be used as additional criteria to identify children needing high level of care.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2015-309665","type":"journal-article","created":{"date-parts":[[2016,6,9]],"date-time":"2016-06-09T18:42:59Z","timestamp":1465497779000},"page":"1004-1009","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Retrospective study of imported falciparum malaria in French paediatric intensive care units"],"prefix":"10.1136","volume":"101","author":[{"given":"Justine","family":"Lanneaux","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Dauger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luu-Ly","family":"Pham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9r\u00f4me","family":"Naudin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Faye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Gillet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Bosdure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Carbajal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Dubos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renaud","family":"Vialet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e9rard","family":"Ch\u00e9ron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Angoulvant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,6,8]]},"reference":[{"key":"key-10.1136\/archdischild-2015-309665-1","volume-title":"Guidelines for the treatment of malaria","author":"World Health Organisation","year":"2015","edition":"3"},{"key":"key-10.1136\/archdischild-2015-309665-2","doi-asserted-by":"crossref","DOI":"10.1596\/978-0-8213-8828-0","volume-title":"World Malaria Report 2011","author":"World Health Organisation","year":"2011"},{"key":"key-10.1136\/archdischild-2015-309665-3"},{"key":"key-10.1136\/archdischild-2015-309665-4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1136\/archdischild-2011-300175","article-title":"Aetiology and epidemiology of fever in children presenting to the emergency department of a French paediatric tertiary care centre after international travel","volume":"97","author":"Naudin","year":"2012","journal-title":"Arch Dis Child"},{"issue":"1","key":"key-10.1136\/archdischild-2015-309665-5","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S0035-9203(00)90300-6","article-title":"Severe falciparum malaria","volume":"94","author":"World Health Organisation","year":"2000","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"key-10.1136\/archdischild-2015-309665-6","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1093\/eurpub\/ckm101","article-title":"Imported malaria in children: a national surveillance in the Netherlands and a review of European studies","volume":"18","author":"Driessen","year":"2008","journal-title":"Eur J Public Health"},{"key":"key-10.1136\/archdischild-2015-309665-7","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1097\/INF.0b013e3181c4d97c","article-title":"Prospective, national clinical and epidemiologic study on imported childhood malaria in the United Kingdom and the Republic of Ireland","volume":"29","author":"Ladhani","year":"2010","journal-title":"Pediatr Infect Dis J"},{"key":"key-10.1136\/archdischild-2015-309665-8","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/S1473-3099(07)70110-X","article-title":"Imported malaria in children: a review of clinical studies","volume":"7","author":"Ladhani","year":"2007","journal-title":"Lancet Infect Dis"},{"key":"key-10.1136\/archdischild-2015-309665-9","author":"World Health Organisation","year":"2012","journal-title":"Management of severe malaria: a practical handbook"},{"key":"key-10.1136\/archdischild-2015-309665-10","unstructured":"World Health Organization. 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