Deep Breathing in Children with Severe Malaria: Indicator of Metabolic Acidosis and Poor Outcome

• DOI: 10.4269/ajtmh.1996.55.521
• Publication Date: 2017-05-10T16:42:29Z
• Authors: Michael English; Catherine Waruiru; Evans Amukoye; Stephen Murphy; Jane Crawley; Isaiah Mwangi; Norbert Peshu; Kevin Marsh
• Keywords: Respiration; Prognosis; Sensitivity and Specificity; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Humans; Prospective Studies; Malaria, Falciparum; Acidosis; Child; Respiratory Insufficiency

Despite the frequent association of respiratory symptoms and signs with malarial morbidity mortality in sub-Saharan Africa, value individual has rarely been assessed. We have prospectively examined clinical findings summary diagnosis distress, outcome, presence metabolic acidosis children admitted severe malaria to a Kenyan district hospital. Respiratory distress was present 119 350 included study 23 30 deaths (relative risk = 6.5, 95% confidence interval 2.8–14.4). The features history dyspnea, nasal flaring, indrawing or deep breathing (Kussmaul's respiration) were individually most closely associated distress. Of these, breathing, which sensitive (91%) specific (83%) for (base excess ≤ -12), is best candidate sign represent prognostically important syndrome Therefore, it warrants further prospective evaluation different settings areas endemicity.