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Table 2 Clinical details of the patients whose deaths were associated with vivax malaria

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  
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 1 month prior 1,1,1 Vivax malaria with extreme anaemia and renal failure  
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 5 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 3 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   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   - 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 6 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 5 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 2 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
  1. aResearch microscopy done; bParacheck Pf® done. AIDS; acquired immunodeficiency syndrome, ARDS; acute respiratory distress syndrome, CXR; chest X-ray, d; day, h; hour, ETT; endotracheal tube, GI; gastrointestinal, HIV; human immunodeficiency virus, L; left, LLL; left lower lobe, m; month, NSAID; non-steroidal anti-inflammatory drug, Pv; Plasmodium vivax, R; right, RLL; right lower lobe, RML; right middle lobe, RUL; right upper lobe, y; year. To comply with the BMC policy on patient confidentiality, details on gender were removed from the table to ensure there were less than three indirect identifiers per patient.