From: Mortality attributable to Plasmodium vivaxmalaria: a clinical audit from Papua, Indonesia
Category | No. | Age | Time to death | Weight (kg) | Documented malnutrition | Documented Pv in last year | Vivax parasitaemia | Haemoglobin (g/dL) | White cell count (μl -1) | Platelets × 10 3 μl -1 | Bilirubin (mmol/L) | Creatinine (μmol/L) | Glucose (mmol/L) | Bicarbonate (mmol/L) | CXR | Individual assessors’ classifications | Primary cause of death | Indirect causes |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Primary cause | 1 | 19y | 1d | 40 | N | 2 | ++++ | 2.2 | 7,000 | 11 | 135.6 | 105 | 8.2 | - | - | 1,1,1 | Vivax malaria with extreme anaemia associated with hyperbilirubinaemia | Â |
2a | 1y7m | 1d | 7 | Y | 1 | ++ | 4.7 | 8,000 | 142 | - | - | - | - | - | 1,1,1 | Vivax malaria | Malnutrition | |
3 | 24y | 4d | 56 | N | 0 | ++++ | 2.6 | 16100 | 51 | 29.2 | 248 | 6.1 | - | Resolving minor RLL consolidation compared with film 1Â month prior | 1,1,1 | Vivax malaria with extreme anaemia and renal failure | Â | |
4b | 10 m | 3d | 7 | Y | 0 | ++++ | 1.9 | 11,800 | 64 | - | - | 13.5 | 3.0 | Day 0 – normal Day 2 – whiteout of R lung and part of L lung. Pulmonary oedema in remainder of L lung | 1,1,1 | Vivax malaria with extreme anaemia and respiratory distress associated with acidosis | Malnutrition | |
5 | 1y9m | 2d | 11 | N | 0 | ++++ | 1.7 | 20,100 | 139 | 116.3 | - | 5.6 | - | - | 1,1,1 | Vivax malaria with extreme anaemia associated with hyperbilirubinaemia | Possible underlying sepsis | |
2. Major contributor | 6 | 3m26d | 5Â h | - | N | 0 | + | 2.8 | 29,000 | 123 | - | - | 6.5 | - | Normal | 1,1,2 | Vivax malaria with extreme anaemia | Possible underlying sepsis |
7a | 4y4m | 2d | 10 | Y | 0 | ++++ | 8.6 | 14,300 | 13 | 13.5 | - | 4.8 | - | Normal | 2,2,2 | Respiratory tract infection | Malnutrition Vivax malaria | |
8a | 3y1m | 3Â h | 12 | N | 0 | ++ | - | - | - | - | - | - | - | Normal | 2,2,2 | Respiratory tract infection | Vivax malaria | |
9 | 1y9m | 7d | 8 | Y | 3 | +++ | 9.2 | 11,000 | 163 | - | - | - | - | - | 1,2,2 | Malnutrition with sepsis | Vivax malaria | |
10 | 1y8m | 4d | 8 | Y | 0 | ++++ | 5.1 | 4,200 | 154 | - | - | - | - | Poor inspiratory effort, unable to assess | 2,2,2 | Respiratory tract infection | Malnutrition Vivax malaria | |
11 | 1y8m | 1d | - | Y | 0 | +++ | 7.3 | 13,900 | 13 | - | 56 | 21.8 | Â | Normal | 1,2,3 | Respiratory tract infection | Vivax malaria Malnutrition | |
12a | 1y3m | 9d | 6 | Y | 3 | +++ | 12.5 | 25,300 | 136 | 5.3 | - | 6.8 | Â | - | 2,2,3 | Diarrhoeal disease | Malnutrition Vivax malaria | |
13 | 1y | 7d | 6 | Y | 0 | ++ | 7.9 | 8,300 | 105 | - | 43 | 4.6 | 9.8 | Normal | 3,2,2 | Diarrhoeal disease associated with acidosis | Vivax malaria Malnutrition | |
14 | 38y | 13d | 26 | Y | 0 | +++ | 6.3 | 14,300 | 55 | - | 106 | 6.0 | - | Minor chronic changes in LLL | 2,2,2 | AIDS | Vivax malaria Malnutrition | |
15 | 2y | 2d | 12 | Y | 0 | + | 4.4 | 10,600 | 21 | 23.4 | 48 | 4.3 | 26.7 | Evidence of pneumonia | 2,2,2 | Respiratory tract infection | Vivax malaria Malnutrition | |
16 | 1y5m | 17d | 5 | Y | 3 | ++ | 6.7 | 9,500 | 262 | - | - | 6.0 | - | Diffuse changes consistent with pneumonia, R > L | 2,2,2 | AIDS | Vivax malaria Malnutrition Tuberculosis | |
17 | 27y | 5d | - | N | 1 | + | 6.5 | 3,800 | 80 | - | - | - | 19.2 | - | 2,2,2 | AIDS | Vivax malaria | |
18 | 1y23d | 6Â h | 9 | N | 0 | +++ | 5.8 | 4,700 | 229 | - | 44 | 8.7 | 9.3 | RUL consolidation | 2,2,2 | Bronchopneumonia associated with acidosis | Vivax malaria | |
19 | 34y | 8 h | 50 | N | 0 | ++ | 5.8 | 14,100 | 252 | - | - | 4.9 | 2.2 | Bilaterally increased lung markings, R > L, consistent with ARDS or pneumonia | 2,2,2 | Chronic renal failure associated with acidosis | Vivax malaria Respiratory tract infection | |
20b | 61y | 6d | 50 | N | 0 | + | 4.1 | 3,500 | 9 | 21.7 | 2378 | 5.3 | 13.6 | RML collapse with consolidation, calcification and scarring | 2,2,2 | Chronic renal failure with respiratory tract infection associated with acidosis | Vivax malaria | |
21a,b | 25y | 5Â h | 75 | N | 0 | + | 6.2 | 23,700 | 22 | - | 97 | 15.4 | - | - | 2,2,2 | GI bleeding secondary to NSAID | Vivax malaria | |
22b | 3y | 1d | 11 | N | 0 | ++ | 9.4 | 9,600 | 152 | - | 114 | 1.7 | 13.3 | Admission – underexposed but probably normal Later in the day – collapsed L lung with ETT in R main bronchus. R lung normal | 2,2,2 | Sepsis associated with hypoglycaemia and acidosis | Vivax malaria Trauma | |
23b | 14y | 8d | - | N | 0 | +++ | 2.1 | 4,200 | 89 | 19.0 | 1680 | - | 2.2 | - | 2,2,3 | Uraemia secondary to endstage chronic renal failure associated with acidosis | Vivax malaria exacerbating severe anaemia | |
3. Minor contributor | 24 | 2y4m | 6d | 9 | Y | 1 | ++ | 13.0 | 12,600 | 231 | 40.4 | - | 6.9 | - | - | 2,3,3 | Diarrhoeal disease | Sepsis Malnutrition Vivax malaria |
25 | 59y | 3d | 50 | N | 0 | + | 10.5 | 35,500 | 173 | 33.5 | 228 | 4.2 | - | - | 3,3,3 | Respiratory sepsis | COPD Vivax malaria Ischemic heart disease | |
26 | 2y10m | 5d | 12 | Y | 1 | + | 9.0 | 13200 | 124 | - | 12 | 5.8 | 22.8 | Dense, bilateral patchy consolidation L > R | 3,3,3 | Tuberculosis with sepsis | Vivax malaria Malnutrition | |
27a | 18y | 1d | 50 | N | 0 | ++ | 15.5 | 16,100 | 100 | - | 332 | 11.4 | 17.1 | Normal | 3,3,3 | Meningitis associated with renal failure | Vivax malaria | |
28a | 60y | 1d | 37 | N | 0 | + | 11.5 | 11,800 | 119 | - | 600 | 5.7 | - | - | 3,3,4 | Hepatorenal syndrome | Vivax malaria Possible bacterial infection | |
29 | 1y8m | 1d | 7 | N | 1 | ++ | 9.8 | 79,300 | 580 | - | - | 2.4 | 9.9 | CXR 2Â days prior showed infiltrate obscuring L heart border | 3,3,3 | Respiratory tract infection with overwhelming sepsis and acidosis | Vivax malaria Malnutrition | |
30 | 24y | 5d | 33 | N | 2 | + | 4.7 | 1,500 | 85 | 6.7 | 132 | 5.7 | 21.9 | Worsening RML consolidation and cavitation compared with previous films. L mid and lower zone consolidation and cavitation. R mediastinal mass | 3,3,3 | AIDS with tuberculosis | Vivax malaria | |
31 | 5m4d | 12d | 7 | N | 0 | ++ | 13.0 | 7,200 | 107 | - | - | - | 13.9 | Infiltrate at R hilum | 3,4,3 | Bronchopneumonia associated with acidosis | Vivax malaria | |
32 | 1y8m | 1d | 6 | Y | 0 | ++++ | 10.2 | 19,700 | 110 | - | 66 | 1.2 | - | Normal | 3,3,3 | Diarrhoeal disease with hypovolaemic shock | Vivax malaria Malnutrition | |
33 | 55y | 4d | 60 | N | 0 | ++++ | 10.1 | 19,500 | 55 | - | 521 | 3.7 | - | Increased lung markings bilaterally | 3,3,3 | Sepsis and renal failure | Vivax malaria | |
34 | 4y | 1d | 16 | N | 0 | + | 11.2 | 22,700 | 461 | - | - | 6.0 | - | - | 3,3,3 | GI sepsis | Vivax malaria | |
35 | 31y | 10d | 38 | Y | 1 | + | 9.9 | 3,700 | 114 | 3.4 | 131 | 4.6 | - | - | 3,3,3 | HIV associated enteropathy | Malnutrition Vivax malaria | |
36 | 3y6m | 15d | 12 | Y | 2 | ++ | 8.9 | 27,700 | 3 | 63.3 | - | - | 33.2 | Poor inspiratory effort, unable to assess | 3,3,4 | Respiratory tract infection with overwhelming sepsis associated with hyperbilirubinaemia | Malnutrition Vivax malaria |