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;()# $**0*&$.-,# 30&'# &',# *&%+7#we wish to thank Eric Borgstein (Queen Elizabeth
Hospital, Blantyre, Malawi); Grace Matimati, Patricia Phula, Simon Ewing and the
Paediatric Research Ward clinical team (Wellcome Trust Clinical Research
Programme and Blantyre Malaria Project) and the Department of Paediatrics and
Child Health B\%,,.#X"0]$6,&'#L(*50&$">#^"$.&7),>#C$"$30I1#
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Table 1. Clinical characteristics and soluble plasma markers in children with cerebral malaria, uncomplicated malaria, mild febrile illness and healthy controls
Healthy controls (n=36)
Mild febrile illness (n=88)
Uncomplicated malaria (n=84)
Cerebral malaria (n=18) Age - years - mean (95% CI1) 4.6 (3.7-5.7) 3.2 (2.8-3.6)* 4.7 (4.1-5.3) 4.1 (3.3-5.2)
Female sex - number (%) 13 (36) 35 (40) 47 (56) 8 (44)
Clinical parameters on day 0 - mean (95% CI):
Axillary temperature 36.6 (36.5-36.7) 38.4 (38.2-38.5)*** 38.5 (38.4-38.7)*** 39.0 (38.5-39.6)***
Heart rate - beats/ min 109 (104-114) 127 (119-135)*** 130 (124-137)*** 145 (129-163)***
Systolic blood pressure - mmHg 107 (101-113) 114 (110-117)* 113 (110-117)* 97 (92-102)**
Respiratory rate - breaths/ min 28 (26-30) 30 (29-31) 28 (27-29) 46 (42-51)***
Glucose - mmol/ L 5.0 (4.8-5.2) 5.1 (4.9-5.3) 5.7 (5.4-6.0)** 5.6 (4.6-6.9)*
Lactate - mmol/ L 1.8 (1.7-2.0) 1.7 (1.6-1.9) 2.3 (2.1-2.5) 5.2 (3.9-6.9)***
Hemoglobin - g/ L 10.4 (9.9-11.0) 10.7 (10.3-11.1) 9.0 (8.6-9.4)** 6.1 (5.4-7.0)***
Platelets - x109/ L 380 (347-416) 300 (267-338)* 110 (93-131)*** 31 (21-46)***
Parasitemia ± parasites x103ȝO 0 0 20 (9.9-40) 68 (27-171)
HIV2 positive - number (%) 0 (0) 4 (4.8) 3 (3.5) 2 (11.1)
sICAM-1 pg/ mL day 0 198 (160-247) 316 (295-339)*** 464 (295-505)*** 624 (377-1033)***
sICAM-1 pg/ mL day 7 - 258 (235-282) 343 (299-394)*** 478 (364-626)***
sICAM-1 pg/ mL day 28 - 269 (242-299)* 277 (251-304)** 291 (201-421)
sE-selectin pg/ mL day 0 68 (57-82) 122 (105-142)*** 147 (130-160)*** 205 (158-266)***
sE-selectin pg/ mL day 7 - 76 (66-87) 79 (68-91) 109 (77-154)*
sE-selectin pg/ mL day 28 - 79 (68-92) 82 (74-91) 93 (64-135)
Ang-2 pg/ mL day 0 232 (207-261) 382 (339-431)*** 579 (523-641)*** 1536 (1190-1982)***
Ang-2 pg/ mL day 7 - 383 (333-440)*** 442 (389-502)*** 548 (401-749)***
Ang-2 pg/ mL day 28 - 311 (275-350)** 320 (285-359)** 307 (213-443)
sTM pg/ mL day 0 4.7 (4.2-5.2) 4.5 (4.2-4.9) 6.0 (5.4-6.5)* 9.1 (7.5-11.1)***
sTM pg/ mL day 7 - 4.7 (4.3-5.1) 5.0 (4.4-5.6) 5.6 (4.3-7.2)
sTM pg/ mL day 28 - 5.2 (4.8-5.6) 4.6 (4.1-5.3) 4.1 (3.4-5.1)
CRP mg/ mL enrolment 0.41 (0.23-0.74) 26.7 (20-35)*** 75 (61-92)*** 149 (111-199)***
CRP mg/ mL day 7 - 3.0 (2.0-4.4)*** 5.3 (4.2-6.7)*** 16.0 (8.3-32)***
CRP mg/ mL day 28 - 0.62 (0.37-1.0) 0.73 (0.48-1.1) 12.7 (3.1-52)***
F1+2 pg/ mL day 0 176 (140-220) 142 (120-167) 219 (180-268) 376 (245-577)*
F1+2 pg/ mL day 7 - 176 (135-229) 220 (186-260) 500 (279-898)***
F1+2 pg/ mL day 28 - 174 (138-221) 142 (111-182) 180 (105-310)
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224 fully conscious patients aged1-12 with
temperature >38.5 screened for enrollment
91 had positive RDT 94 had negative RDT
185 met all inclusion criteria and gave consent
4 blood sample not collected 2 withdrew
3 blood sample not collected 4 had negative smears
for malaria
88 in non-malarial febrile
illness group at day 0 malaria group at day 0 84 in uncomplicated
30 patients did not attend follow up
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41 patients followed up to 1 month 47 patients followed up to
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39 well children attending routine surgery
aged 1-12 screened for enrollment
36 met all inclusion criteria and gave consent
36 in healthy controls group day 0
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Cerebral malaria
43 comatose children aged 1-12 with cerebral
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18 met all inclusion criteria and gave consent
4 patients did not attend follow up
1 died 1 had parasitaemia at
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group at day 0
10 patients followed up to 1 month
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