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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 geertruydenComments to Author 
Author affiliations: Tropical Diseases Research Centre, Ndola, Zambia (V. Chalwe, D. Mukwamataba, M. Mulenga); Institute of Tropical Medicine, Antwerp, Belgium (J.-P. Van geertruyden, J. Menten, U. D’Alessandro); Thomson Hospital, Luanshya, Zambia (J. Kamalamba)

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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.

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