Prognostic Factors in Severe Falciparum Malaria

Editorial In 2012, prognostic factors in severe falciparum malaria were mentioned in World Health Organization (WHO)’s handbook of management of severe malaria [1]. Those factors included 9 clinical factors and 17 laboratory factors. Some factors reflect vital organ dysfunction similar to definition of severe falciparum malaria such as clinical signs of organ dysfunction (eg. renal injury, pulmonary edema), shock, respiratory distress (acidosis), hypoglycemia, hyperlactatemia, creatinine>3 mg/dl with renal impairment and anemia with hemoglobin < 5 g/dl. Some factors indicate magnitude of disease severity such as deep coma, absent corneal reflexes, papilledema, hyperparasitemia (>250,000/µl or>5%), blood urea nitrogen>60 mg/dl, high cerebrospinal (CSF) lactate (>6 mmol/l) and low CSF glucose, greater than 3 fold elevation in serum transaminases, increased plasma 5ˊ-nucleotidase, raised muscle enzymes, lo