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Table 1 Clinical characteristics at baseline by level of haemoglobin

From: Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness

  Severe anaemia (Hb <5 g/dL) Moderate anaemia (5 to <7 g/dL) Mild anaemia (7 to <10 g/dL) No anaemia (≥10 g/dL) Total P value
N (%)1 1,002 (33%) 501 (16%) 843 (27%) 736 (24%) 3,082  
General       
Age (months); median (IQR) 25 (15, 42) 23 (13, 36) 19 (12, 34) 24 (14, 45) 24 (13, 38) 0.02
Female 439 (44%) 245 (49%) 367 (44%) 364 (49%) 1415 (46%) 0.1
Weight-for-age z-score; median (IQR) −1.6 −1.6 −1.5 −1.3 −1.5 <0.001
(−2.5, –0.8) (−2.6, –0.8) (−2.4, –0.6) (−2.2, −0.5) (−2.4, −0.7)
Axillary Temperature >39°C 109 (11%) 119 (24%) 261 (31%) 234 (32%) 723 (24%) <0.001
Respiratory       
Respiratory rate; mean (SD) 56.1 (13.8) 56.5 (14.5) 60.3 (15.8) 58.0 (16.6) 57.8 (15.3) <0.001
Respiratory distress 845 (85%) 410 (82%) 694 (83%) 574 (78%) 2,523 (82%) 0.001
Chest indrawing 686 (69%) 322 (64%) 576 (68%) 483 (66%) 2,067 (67%) 0.39
Deep breathing 745 (75%) 329 (66%) 485 (58%) 424 (58%) 1,983 (65%) <0.001
Oxygen saturation ≤90% 260 (28%) 107 (22%) 187 (23%) 195 (27%) 749 (25%) 0.36
Cardiovascular       
Weak radial pulse 298 (29%) 113 (23%) 139 (16%) 107 (15%) 657 (21%) <0.001
Lower limb temperature gradient2 661 (66%) 295 (59%) 467 (55%) 394 (53%) 1,883 (59%) <0.001
Capillary refill time (3 or more seconds) 573 (57%) 115 (23%) 80 (9%) 50 (7%) 818 (27%) <0.001
Severe tachycardia3 616 (62%) 377 (75%) 623 (74%) 544 (74%) 2,160 (70%) <0.001
Bradycardia 18 (2%) 3 (<1%) 6 (<1%) 8 (1%) 35 (1%) 0.11
Systolic blood pressure; median (IQR) 88 (81, 96) 93 (86, 101) 94 (86, 102) 98 (89, 106) 93 (85, 101) <0.001
Moderate hypotension4 100 (10%) 25 (5%) 43 (5%) 19 (3%) 187 (6%) <0.001
Hypothermia (temperature <36°C) 98 (10%) 24 (5%) 27 (3%) 41 (6%) 190 (6%) <0.001
Dehydration (sunken eyes or reduced skin turgor) 105 (11%) 46 (9%) 51 (6%) 34 (5%) 236 (8%) <0.001
Anaemia       
Severe pallor (pale mucous membranes) 989 (99%) 381 (77%) 167 (20%) 38 (5%) 1,575 (51%) <0.001
Haemoglobinuria (history of dark urine) 282 (28%) 62 (12%) 32 (4%) 9 (1%) 385 (13%) <0.001
Clinical jaundice 584 (58%) 200 (40%) 155 (18%) 35 (5%) 974 (32%) <0.001
Neurological       
Prostrate5 726 (73%) 328 (66%) 466 (55%) 387 (53%) 1,907 (62%) <0.001
Coma6 129 (13%) 89 (18%) 142 (17%) 98 (13%) 458 (15%) 0.55
Convulsions in this illness 264 (27%) 212 (42%) 358 (42%) 320 (44%) 1,154 (37%) <0.001
Laboratory tests       
Positive malaria parasitaemia7 593 (59%) 377 (75%) 462 (55%) 317 (43%) 1,749 (57%) <0.001
Hyperparasitaemia8 34/592 (6%) 41/308 (13%) 42/569 (7%) 32/504 (6%) 149/1,973 (8%) 0.86
Glucose <2.5 mmol/L 52 (5%) 28 (6%) 31 (4%) 23 (3%) 134 (5%) 0.02
Lactate ≥5 mmol/L 672 (70%) 218 (45%) 184 (23%) 75 (11%) 1,149 (39%) <0.001
Base deficit >8 392/632 (62%) 189/329 (58%) 254/554 (45%) 239/539 (44%) 1,074/2,054 (52%) <0.001
Severe acidaemia (pH <7.2) 97/635 (15%) 38/291 (12%) 48/556 (9%) 30/511 (6%) 213/2,061 (10%) 0.82
Hyperkalaemia (>6.5 mmol/L) 83/630 (13%) 41/330 (12%) 54/559 (10%) 28/536 (5%) 206/2,055 (10%) <0.001
HIV antibody positive 17/790 (2%) 25/390 (6%) 36/666 (5%) 31/615 (5%) 109/2,461 (4%) 0.008
Positive blood culture 25/234 (11%) 32/179 (18%) 36/341 (11%) 35/317 (10%) 128/1,071 (12%) 0.52
  1. 1Of 3,170 children enrolled in the FEAST trial, 88 did not have haemoglobin measured at baseline.
  2. 2Temperature gradient was assessed by running the back of the hand from the toe to the knee; a positive temperature gradient was defied as a notable temperature change from cold (dorsum of foot) to warm (knee).
  3. 3Severe tachycardia was defined as >180 beats per minute (bpm) in children <12 months, >160 bpm in children aged 12 months to 5 years, and >140 bpm for those aged >5 years.
  4. 4Moderate hypotension was defined as systolic blood pressure of 50 to 75 mmHg in children younger than 12 months, 60 to 75 mmHg in those 12 months to 5 years, and 70 to 85 mmHg in those older than 5 years, as measured by automated blood pressure monitor.
  5. 5Prostration was defined as the inability of a child older than 8 months of age to sit upright or the inability of a child 8 months of age or younger to breast feed.
  6. 6Coma was defined as the inability to localise a painful stimulus.
  7. 7Positive on quality-controlled malaria slide, or, if missing, on rapid diagnostic test.
  8. 8Parasite count >250,000 per μL or, for 133 children in whom quantitative parasite count was unavailable, percentage parasitaemia >10%. No information on parasite density was available for 1,109/3,082 (36%) children.
  9. IQR, Interquartile range; SD, Standard deviation.