{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T13:20:37Z","timestamp":1784985637432,"version":"3.55.0"},"reference-count":72,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,2]],"date-time":"2023-04-02T00:00:00Z","timestamp":1680393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"CIHR Foundation","doi-asserted-by":"publisher","award":["FDN-148439"],"award-info":[{"award-number":["FDN-148439"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"CIHR Foundation","doi-asserted-by":"publisher","award":["3281"],"award-info":[{"award-number":["3281"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"CIHR Foundation","doi-asserted-by":"publisher","award":["S6 0486-01-10"],"award-info":[{"award-number":["S6 0486-01-10"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tesari Foundation and Kim Kertland (KCK)","award":["FDN-148439"],"award-info":[{"award-number":["FDN-148439"]}]},{"name":"Tesari Foundation and Kim Kertland (KCK)","award":["3281"],"award-info":[{"award-number":["3281"]}]},{"name":"Tesari Foundation and Kim Kertland (KCK)","award":["S6 0486-01-10"],"award-info":[{"award-number":["S6 0486-01-10"]}]},{"name":"Women and Children\u2019s Health Research Institute","award":["FDN-148439"],"award-info":[{"award-number":["FDN-148439"]}]},{"name":"Women and Children\u2019s Health Research Institute","award":["3281"],"award-info":[{"award-number":["3281"]}]},{"name":"Women and Children\u2019s Health Research Institute","award":["S6 0486-01-10"],"award-info":[{"award-number":["S6 0486-01-10"]}]},{"name":"Grand Challenges Canada","award":["FDN-148439"],"award-info":[{"award-number":["FDN-148439"]}]},{"name":"Grand Challenges Canada","award":["3281"],"award-info":[{"award-number":["3281"]}]},{"name":"Grand Challenges Canada","award":["S6 0486-01-10"],"award-info":[{"award-number":["S6 0486-01-10"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Respiratory distress (RD) in pediatric malaria portends a grave prognosis. Lactic acidosis is a biomarker of severe disease. We investigated whether lactate, measured at admission using a handheld device among children hospitalized with malaria and RD, was predictive of subsequent mortality. We performed a pooled analysis of Ugandan children under five years of age hospitalized with malaria and RD from three past studies. In total, 1324 children with malaria and RD (median age 1.4 years, 46% female) from 21 health facilities were included. Median lactate level at admission was 4.6 mmol\/L (IQR 2.6\u20138.5) and 586 patients (44%) had hyperlactatemia (lactate &gt; 5 mmol\/L). The mortality was 84\/1324 (6.3%). In a mixed-effects Cox proportional hazard model adjusting for age, sex, clinical severity score (fixed effects), study, and site (random effects), hyperlactatemia was associated with a 3-fold increased hazard of death (aHR 3.0, 95%CI 1.8\u20135.3, p &lt; 0.0001). Delayed capillary refill time (\u03c4 = 0.14, p &lt; 0.0001), hypotension (\u03c4 = \u22120.10, p = 0.00049), anemia (\u03c4 = \u22120.25, p &lt; 0.0001), low tissue oxygen delivery (\u03c4 = \u22120.19, p &lt; 0.0001), high parasite density (\u03c4 = 0.10, p &lt; 0.0001), and acute kidney injury (p = 0.00047) were associated with higher lactate levels. In children with malaria and RD, bedside lactate may be a useful triage tool, predictive of mortality.<\/jats:p>","DOI":"10.3390\/microorganisms11040923","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T03:32:59Z","timestamp":1680492779000},"page":"923","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pediatric Malaria with Respiratory Distress: Prognostic Significance of Point-of-Care Lactate"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8433-0466","authenticated-orcid":false,"given":"Catherine","family":"Mitran","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert O.","family":"Opoka","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Mulago Hospital and Makerere University, Kampala P.O. Box 7062, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea L.","family":"Conroy","sequence":"additional","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN 46202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Namasopo","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Kabale District Hospital, Kabale P.O. Box 1102, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6068-1272","authenticated-orcid":false,"given":"Kevin C.","family":"Kain","sequence":"additional","affiliation":[{"name":"Sandra Rotman Centre for Global Health, Department of Medicine, University Health Network-Toronto General Hospital, University of Toronto, Toronto, ON M5G 1L7, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 1L7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4122-0937","authenticated-orcid":false,"given":"Michael T.","family":"Hawkes","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"},{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"},{"name":"School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada"},{"name":"Stollery Science Lab, Edmonton, AB T6G 1C9, Canada"},{"name":"Women and Children\u2019s Health Research Institute, Edmonton, AB T6G 1C9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,2]]},"reference":[{"key":"ref_1","unstructured":"(2022). World Malaria Report 2022, World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/bs.apar.2015.02.004","article-title":"PfEMP1\u2014A Parasite Protein Family of Key Importance in Plasmodium falciparum Malaria Immunity and Pathogenesis","volume":"88","author":"Hviid","year":"2015","journal-title":"Adv. Parasitol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1038\/415673a","article-title":"The pathogenic basis of malaria","volume":"415","author":"Miller","year":"2002","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/j.1365-3024.2006.00808.x","article-title":"Immune effector mechanisms in malaria","volume":"28","author":"Marsh","year":"2006","journal-title":"Parasite Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1056\/NEJM199505253322102","article-title":"Indicators of life-threatening malaria in African children","volume":"332","author":"Marsh","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/0035-9203(94)90504-5","article-title":"Lactic acidosis and hypoglycaemia in children with severe malaria: Pathophysiological and prognostic significance","volume":"88","author":"Krishna","year":"1994","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/21505594.2020.1726570","article-title":"Predictors of outcome in childhood Plasmodium falciparum malaria","volume":"11","author":"Patel","year":"2020","journal-title":"Virulence"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1378\/chest.11-2655","article-title":"Respiratory manifestations of malaria","volume":"142","author":"Taylor","year":"2012","journal-title":"Chest"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"521","DOI":"10.4269\/ajtmh.1996.55.521","article-title":"Deep breathing in children with severe malaria: Indicator of metabolic acidosis and poor outcome","volume":"55","author":"English","year":"1996","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"256","DOI":"10.4269\/ajtmh.2007.77.256","article-title":"Metabolic acidosis and other determinants of hemoglobin-oxygen dissociation in severe childhood Plasmodium falciparum malaria","volume":"77","author":"Sasi","year":"2007","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1186\/s13054-015-1023-5","article-title":"The role of previously unmeasured organic acids in the pathogenesis of severe malaria","volume":"19","author":"Herdman","year":"2015","journal-title":"Crit. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1097\/00003246-200006000-00025","article-title":"The pathophysiologic and prognostic significance of acidosis in severe adult malaria","volume":"28","author":"Day","year":"2000","journal-title":"Crit. Care Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/S0140-6736(88)92658-X","article-title":"Cerebral anaerobic glycolysis and reduced cerebral oxygen transport in human cerebral malaria","volume":"2","author":"Warrell","year":"1988","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1086\/432941","article-title":"The prognostic value of measures of acid\/base balance in pediatric falciparum malaria, compared with other clinical and laboratory parameters","volume":"41","author":"Newton","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1086\/377536","article-title":"A prospective comparison of malaria with other severe diseases in African children: Prognosis and optimization of management","volume":"37","author":"Planche","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Aramburo, A., Todd, J., George, E.C., Kiguli, S., Olupot-Olupot, P., Opoka, R.O., Engoru, C., Akech, S.O., Nyeko, R., and Mtove, G. (2018). Lactate clearance as a prognostic marker of mortality in severely ill febrile children in East Africa. BMC Med., 16.","DOI":"10.1186\/s12916-018-1014-x"},{"key":"ref_17","first-page":"99","article-title":"Acid-base status in paediatric Plasmodium falciparum malaria","volume":"86","author":"Taylor","year":"1993","journal-title":"Q. J. Med."},{"key":"ref_18","unstructured":"World Health Organization (2012). Management of Severe Malaria: A Practical Handbook, WHO. [3rd ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1136\/adc.72.4.334","article-title":"Interobserver variation in respiratory signs of severe malaria","volume":"72","author":"English","year":"1995","journal-title":"Arch. Dis. Child."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Jallow, M., Casals-Pascual, C., Ackerman, H., Walther, B., Walther, M., Pinder, M., Sisay-Joof, F., Usen, S., Jallow, M., and Abubakar, I. (2012). Clinical features of severe malaria associated with death: A 13-year observational study in the Gambia. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0045645"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1186\/s12936-020-03390-7","article-title":"The clinical spectrum of severe childhood malaria in Eastern Uganda","volume":"19","author":"Engoru","year":"2020","journal-title":"Malar. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s00421-017-3795-6","article-title":"Lactate metabolism: Historical context, prior misinterpretations, and current understanding","volume":"118","author":"Ferguson","year":"2018","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Brand, N.R., Opoka, R.O., Hamre, K.E., and John, C.C. (2016). Differing Causes of Lactic Acidosis and Deep Breathing in Cerebral Malaria and Severe Malarial Anemia May Explain Differences in Acidosis-Related Mortality. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0163728"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1086\/523762","article-title":"Direct in vivo assessment of microcirculatory dysfunction in severe falciparum malaria","volume":"197","author":"Dondorp","year":"2008","journal-title":"J. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1086\/595735","article-title":"Perfusion abnormalities in children with cerebral malaria and malarial retinopathy","volume":"199","author":"Beare","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3233\/CH-2010-1354","article-title":"Erythrocytapheresis and sublingual micro-vascular flow in severe malaria","volume":"46","author":"Siegenthaler","year":"2010","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0166-6851(90)90171-H","article-title":"D-lactate production in erythrocytes infected with Plasmodium falciparum","volume":"42","author":"Hunsaker","year":"1990","journal-title":"Mol. Biochem. Parasitol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Possemiers, H., Vandermosten, L., and Van den Steen, P.E. (2021). Etiology of lactic acidosis in malaria. PLoS Pathog., 17.","DOI":"10.1371\/journal.ppat.1009122"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"ofw046","DOI":"10.1093\/ofid\/ofw046","article-title":"Acute Kidney Injury Is Common in Pediatric Severe Malaria and Is Associated With Increased Mortality","volume":"Volume 3","author":"Conroy","year":"2016","journal-title":"Open Forum Infectious Diseases"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e734","DOI":"10.1097\/CCM.0000000000004469","article-title":"Endothelial Activation, Acute Kidney Injury, and Cognitive Impairment in Pediatric Severe Malaria","volume":"48","author":"Ouma","year":"2020","journal-title":"Crit. Care Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"235","DOI":"10.2147\/IJNRD.S239157","article-title":"Malaria-Associated Acute Kidney Injury in African Children: Prevalence, Pathophysiology, Impact, and Management Challenges","volume":"14","author":"Batte","year":"2021","journal-title":"Int. J. Nephrol. Renovasc. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Hawkes, M.T., Leligdowicz, A., Batte, A., Situma, G., Zhong, K., Namasopo, S., Opoka, R.O., Kain, K.C., and Conroy, A.L. (2022). Pathophysiology of Acute Kidney Injury in Malaria and Non-Malarial Febrile Illness: A Prospective Cohort Study. Pathogens, 11.","DOI":"10.3390\/pathogens11040436"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.kint.2019.08.023","article-title":"L-lactic acidosis: Pathophysiology, classification, and causes; emphasis on biochemical and metabolic basis","volume":"97","author":"Kamel","year":"2020","journal-title":"Kidney Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1113\/jphysiol.2002.027128","article-title":"Lactate and glucose interactions during rest and exercise in men: Effect of exogenous lactate infusion","volume":"544","author":"Miller","year":"2002","journal-title":"J. Physiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1186\/s12936-015-0946-2","article-title":"Inhaled nitric oxide as adjunctive therapy for severe malaria: A randomized controlled trial","volume":"14","author":"Hawkes","year":"2015","journal-title":"Malar. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"6832","DOI":"10.1038\/s41467-021-27215-6","article-title":"Risk-stratification of febrile African children at risk of sepsis using sTREM-1 as basis for a rapid triage test","volume":"12","author":"Leligdowicz","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1186\/s13063-019-3752-2","article-title":"Solar-powered oxygen delivery for the treatment of children with hypoxemia: Protocol for a cluster-randomized stepped-wedge controlled trial in Uganda","volume":"20","author":"Conradi","year":"2019","journal-title":"Trials"},{"key":"ref_38","unstructured":"World Health Organization (2021). World Malaria Report, World Health Organization."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kigozi, S.P., Kigozi, R.N., Sebuguzi, C.M., Cano, J., Rutazaana, D., Opigo, J., Bousema, T., Yeka, A., Gasasira, A., and Sartorius, B. (2020). Spatial-temporal patterns of malaria incidence in Uganda using HMIS data from 2015 to 2019. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-10007-w"},{"key":"ref_40","unstructured":"Anderson, K. (2022, November 19). gsDesign: Group Sequential Design. R Package Version 3.2.0. Available online: https:\/\/cran.r-project.org\/web\/packages\/gsDesign\/gsDesign.pdf."},{"key":"ref_41","unstructured":"R Core Team (2019). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4269\/ajtmh.18-0344","article-title":"Handheld Point-of-Care Lactate Measurement at Admission Predicts Mortality in Ugandan Children Hospitalized with Pneumonia: A Prospective Cohort Study","volume":"100","author":"Ma","year":"2019","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1186\/1475-2875-12-167","article-title":"Routine parallel diagnosis of malaria using microscopy and the malaria rapid diagnostic test SD 05FK60: The experience of Medecins Sans Frontieres in Myanmar","volume":"12","author":"Kosack","year":"2013","journal-title":"Malar. J."},{"key":"ref_44","first-page":"203","article-title":"Reliability and accuracy of six hand-held blood lactate analysers","volume":"14","author":"Bonaventura","year":"2015","journal-title":"J. Sports Sci. Med."},{"key":"ref_45","unstructured":"American Heart Association (2020). Pediatric Advanced Life Support Provider Manual, American Heart Association."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1136\/thorax.57.2.170","article-title":"The pulmonary physician in critical care * 2: Oxygen delivery and consumption in the critically ill","volume":"57","author":"Leach","year":"2002","journal-title":"Thorax"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1007\/s00134-012-2676-z","article-title":"Cardiac function in Ghanaian children with severe malaria","volume":"38","author":"Nguah","year":"2012","journal-title":"Intensive Care Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1056\/NEJM198710223171717","article-title":"Simplified calculation of body-surface area","volume":"317","author":"Mosteller","year":"1987","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1152\/jappl.1989.67.2.902","article-title":"Determination of PO2 from saturation","volume":"67","author":"Ellis","year":"1989","journal-title":"J. Appl. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"c179","DOI":"10.1159\/000339789","article-title":"KDIGO clinical practice guidelines for acute kidney injury","volume":"120","author":"Khwaja","year":"2012","journal-title":"Nephron. Clin. Pract."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s00467-011-2081-9","article-title":"A simple height-independent equation for estimating glomerular filtration rate in children","volume":"27","author":"Pottel","year":"2012","journal-title":"Pediatr. Nephrol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Batte, A., Starr, M.C., Schwaderer, A.L., Opoka, R.O., Namazzi, R., Phelps Nishiguchi, E.S., Ssenkusu, J.M., John, C.C., and Conroy, A.L. (2020). Methods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: A prospective cohort study. BMC Nephrol., 21.","DOI":"10.1186\/s12882-020-02076-1"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1086\/648409","article-title":"The Lambarene Organ Dysfunction Score (LODS) is a simple clinical predictor of fatal malaria in African children","volume":"200","author":"Helbok","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_54","unstructured":"Therneau, T.M. (2022, July 29). Coxme: Mixed Effects Cox Models. R Package Version 2.2-16. Available online: https:\/\/CRAN.R-project.org\/package=coxme."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","article-title":"User\u2019s guide to correlation coefficients","volume":"18","author":"Akoglu","year":"2018","journal-title":"Turk. J. Emerg. Med."},{"key":"ref_56","unstructured":"World Health Organization (WHO) (2006). The WHO Child Growth Standards, World Health Organization. Available online: http:\/\/www.who.int\/childgrowth\/standards\/en\/."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S0140-6736(10)62226-X","article-title":"Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: A systematic review of observational studies","volume":"377","author":"Fleming","year":"2011","journal-title":"Lancet"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1111\/j.1365-3156.2011.02831.x","article-title":"Can lay community health workers be trained to use diagnostics to distinguish and treat malaria and pneumonia in children? Lessons from rural Uganda","volume":"16","author":"Mukanga","year":"2011","journal-title":"Trop. Med. Int. Health"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"George, E.C., Walker, A.S., Kiguli, S., Olupot-Olupot, P., Opoka, R.O., Engoru, C., Akech, S.O., Nyeko, R., Mtove, G., and Reyburn, H. (2015). Predicting mortality in sick African children: The FEAST Paediatric Emergency Triage (PET) Score. BMC Med., 13.","DOI":"10.1186\/s12916-015-0407-3"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e160","DOI":"10.1016\/S1473-3099(21)00471-0","article-title":"Fluid therapy for severe malaria","volume":"22","author":"Kalkman","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1056\/NEJMoa1101549","article-title":"Mortality after fluid bolus in African children with severe infection","volume":"364","author":"Maitland","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1093\/cid\/cir471","article-title":"Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital","volume":"53","author":"Mtove","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1038\/jcbfm.2011.175","article-title":"Brain lactate metabolism: The discoveries and the controversies","volume":"32","author":"Dienel","year":"2012","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1006\/jtbi.2002.3030","article-title":"A model for estimating total parasite load in falciparum malaria patients","volume":"217","author":"Gravenor","year":"2002","journal-title":"J. Theor. Biol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Hendriksen, I.C., Mwanga-Amumpaire, J., von Seidlein, L., Mtove, G., White, L.J., Olaosebikan, R., Lee, S.J., Tshefu, A.K., Woodrow, C., and Amos, B. (2012). Diagnosing severe falciparum malaria in parasitaemic African children: A prospective evaluation of plasma PfHRP2 measurement. PLoS Med., 9.","DOI":"10.1371\/journal.pmed.1001297"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"651739","DOI":"10.3389\/fimmu.2021.651739","article-title":"Immunopathology of Acute Kidney Injury in Severe Malaria","volume":"12","author":"Katsoulis","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e0132522","DOI":"10.1128\/mbio.01325-22","article-title":"Intestinal Injury Biomarkers Predict Mortality in Pediatric Severe Malaria","volume":"13","author":"Sarangam","year":"2022","journal-title":"mBio"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1093\/infdis\/jiac340","article-title":"Intestinal Injury in Ugandan Children Hospitalized With Malaria","volume":"226","author":"Ngai","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1093\/infdis\/jiy727","article-title":"Identifying the Components of Acidosis in Patients With Severe Plasmodium falciparum Malaria Using Metabolomics","volume":"219","author":"Leopold","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"605","DOI":"10.4269\/ajtmh.13-0689","article-title":"Performance of point-of-care diagnostics for glucose, lactate, and hemoglobin in the management of severe malaria in a resource-constrained hospital in Uganda","volume":"90","author":"Hawkes","year":"2014","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_71","first-page":"1569","article-title":"Glucose and lactate kinetics in children with severe malaria","volume":"85","author":"Agbenyega","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/BF00493567","article-title":"Estimation and prediction of blood volume in infants and children","volume":"125","author":"Linderkamp","year":"1977","journal-title":"Eur. J. Pediatr."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/4\/923\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:08:39Z","timestamp":1760123319000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/4\/923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,2]]},"references-count":72,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["microorganisms11040923"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms11040923","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,2]]}}}