{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T23:40:13Z","timestamp":1722469213862},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,7]]},"abstract":"<jats:p>The clinical epidemiology of severe malaria among patients presenting to peripheral health centers has not been well described. We conducted a prospective, observational cohort study to describe the epidemiology and clinical manifestations of severe malaria in a highland area of declining transmission intensity in Western Uganda. Individuals presenting with a history of fever were screened with a malaria rapid diagnostic test (RDT). We prepared blood smears and conducted clinical and laboratory testing for those with a positive RDT. We defined severe malaria in accordance with World Health Organization guidelines for research and epidemiological studies. A total of 6,641 individuals underwent testing for malaria. Ninety-six of 1,462 (6.6%) participants with confirmed parasitemia satisfied the criteria for severe malaria. The incidence of severe malaria peaked between 2 and 3 years of age (incidence rate ratio = 17.1, 95% confidence interval = 8.4\u201334.9, <jats:italic>P<\/jats:italic> &lt; 0.001) and then declined steadily until age 10. However, we also found a second peak among those \u2265 50 years of age. Severe anemia was uncommon, detected in only 5.3% of cases. Instead, shock (22.2%) and lactic acidosis (19.4%) were most frequently encountered. Our results suggest that the clinical characteristics of severe malaria presenting to rural, peripheral health centers may be different than previously observed in referral centers. These findings merit further investigation into the optimal methods for identification and management of severe malaria in rural health centers in the region.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0681","type":"journal-article","created":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T07:00:22Z","timestamp":1514358022000},"page":"683-691","source":"Crossref","is-referenced-by-count":2,"title":["Anemia was an Uncommon Complication of Severe Malaria in a High-Transmission Rural Area of Western Uganda"],"prefix":"10.4269","volume":"98","author":[{"given":"Ross","family":"Boyce","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Reyes","sequence":"additional","affiliation":[{"name":"Division of General Medicine & Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinna","family":"Keeler","sequence":"additional","affiliation":[{"name":"Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Matte","sequence":"additional","affiliation":[{"name":"Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Ntaro","sequence":"additional","affiliation":[{"name":"Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar","family":"Mulogo","sequence":"additional","affiliation":[{"name":"Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Siedner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"N Engl J Med","first-page":"2435","article-title":"Mapping Plasmodium falciparum mortality in Africa between 1990 and 2015","volume":"375","author":"Gething","year":"2016"},{"year":"2016","author":"WHO","key":"b2"},{"key":"b3","series-title":"N Engl J Med","first-page":"2416","article-title":"Severe malaria in African children\u2014the need for continuing investment","volume":"375","author":"Maitland","year":"2016"},{"key":"b4","series-title":"Acta Trop","first-page":"289","article-title":"Severe childhood malaria in two areas of markedly different falciparum transmission in east 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