Study | Study inclusion criteria for severe malaria compared to WHO definitiona | N with IBI data | % without IBI data | Overall mortality rate | n IBI | Case fraction (%) with IBI | Case fatality malaria with concomitant IBI (%) | Case fatality malaria without IBI (%) | Overall rating of study quality | Ranking |
---|---|---|---|---|---|---|---|---|---|---|
severe malaria (%) | co-infection | |||||||||
(95% CI) | ||||||||||
Berkley [16] | IC or RD + parasitemia (one slide) Excludes SMA without IC or RD | 643 | 18% | 89/783 (11.4%) | 42 | 6.53 (4.56-8.51) | 14/42 (33%) | 52/498 (10%) | High | YYY |
Berkley [24] | IC or RD or SMA + parasitemia (any of three slides) | 2,048 | 0.5% | 76/861 (8.8%) | 127 | 6.2 (5.12-7.73) | 36/127 (28%) | 137/1921 (7.1%) | High | YYY |
Bronzan [38] | WHO plus asexual parasitemia (slide repeated six hrly). Clinical signs do not include RD | 1,388 | 5.3% | 235/1,388 (16.9%) | 64 | 4.61 (3.48-5.74) | 14/64 (22%) | 211/1324 (16%) | High | YYY |
Evans [24] | WHO definition plus asexual parasitemia (one slide) | 182 | 0% | 16/182 (8.8%) | 23 | 12.64 (7.47-17.8) | 2/23 (8.7%) | 14/159 (8.8%) | High | YYY |
Subtotal | Â | 4,261 | Â | 416/3,224 (12.9) | 256 | 6.01 (5.27-6.74) | Â | Â | Â | Â |
Bassat [23] | WHO signs (incl glucose <2.2 mmol/L) + asexual parasitemia (one thick film) | 1,404 | 12% | 81/1,648 (4.9%) | 76 | 5.41 (4.2-6.63) | 13/59 (22%) | 50/1244 (4.0%) | Moderate | YYN |
Dondorp [2] | WHO definition plus RDT positive; requiring parenteral treatment | 657 | NR (88%) (BC data not available in all patients) | 527/5,425 (9.7%) | 65 | 9.89 (7.49-12.3) | NR | NR | Moderate | YNY |
Enwere [39] | Cerebral malaria (BCS < =2) plus asexual parasitemia) | 276 | 52% (BCx data not consecutive) | 122/576 (21.1%) | 14 | 5.07 (2.42-7.73) | 1/14 (7.1%) | 121/562 (22%) | Moderate | YNY |
Subtotal | Â | 2,337 | Â | Â | 155 | 6.63 (5.59-7.68) | Â | Â | Â | Â |
Angyo [39] | Clinical signs also include hypoglycemia; shock; DIC; acidosis; hemoglobinuria. Did not include confirmed parasitemia. | 501 | NR | 16/501 (3.2%) | 35 | 6.99 (4.67-9.30) | NR | NR | Low | YNN |
Kremsner [42] | Clinical signs also include hyperparasitemia, glucose <2.2. Excludes children with Sickle Cell disease. | 59 | 41% (BCx data not consecutive) | 2/100 (2%) | 7 | 11.86 (3.08-35.1) | 1/7 (14%) | 0/52 (0%) | Low | YNN |
Prada [43] | Cerebral malaria only (not defined) | 50 | Â | NR | 8 | 16.0 (4.91-27.09) | NR | NR | Low | NYN |
Subtotal | Â | 610 | Â | Â | 50 | 8.2 (5.92-24.26) | Â | Â | Â | Â |
Overall total | Â | 7,208 | Â | Â | 461 | 6.40 (5.81-6.98) | 81/336 | 585/5760 | Â | Â |
(24.1%) | (10.2%) |