Volume 15, Number 5—May 2009
CME ACTIVITY
Increased Risk for Severe Malaria in HIV-1–infected Adults, Zambia
Victor Chalwe, Doreen Mukwamataba, Joris Menten, John Kamalamba, Modest Mulenga, Umberto D’Alessandro, and Jean-Pierre Van geertruyden
Table 2
Clinical features of case-patients with severe malaria in case–control study, by HIV-1 infection status, Luanshya, Zambia
| Clinical features | HIV-1 infected, n = 27 | HIV-1 uninfected,* n = 2 |
|---|---|---|
| Signs and symptoms, no. (%) | ||
| Fever (>37.5°C) | 20 (74) | 1 (50) |
| History of fever | 25 (93) | 2 (100) |
| Impaired consciousness (Glasgow Coma Score <10) | 15 (56) | 0 (0) |
| Severe anemia (<7 g/dL)† | 5 (19) | 0 (0) |
| Convulsions | 6 (22) | 0 (0) |
| Jaundice | 3 (11) | 1 (50) |
| Hypoglycemia (<2.5 mmol/L) | 11 (41) | 0 (0) |
| Hyperparasitemia (>100,000 parasites/µL) | 6 (22) | 0 (0) |
| Renal impairment |
0 (0.0) |
0 (0) |
| Leukocyte count, mean 1,000/µL (SD)‡ | 6.9 (3.9) | 4.2 and 8.7 |
| Lymphocytes, % (SD)‡ | 25 (11) | 18 |
| Monocytes, % (SD)‡ | 11 (6) | 5.2 |
| Granulocytes, % (SD)‡ |
62 (20) |
76.8 |
| Parasite density, geometric mean/UL (95% confidence interval) | 43,314 (25,467–81,145) | 11,745 and 38,942 |
| Concomitant antimicrobial drugs |
15 (56) |
0 |
| Outcome | ||
| No. (%) discharged | 24 (82) | 2 (100) |
| Median time hospitalized, d (range) | 5.5 (1–31) | 4 and 17 |
| No. deceased (case-fatality ratio) | 5 (19) | 0 |
| Median length of illness before death, d (range) | 2 (1–11) | – |
*Because only 2 results were HIV negative, no SD or confidence interval was specified.
†Anemia was not an inclusion criterion.
‡Not measured in 4 patients because of technical constraints.
