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Am. J. Trop. Med. Hyg., 75(3), 2006, pp. 443-447
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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SIMPLIFIED MULTI-ORGAN DYSFUNCTION SCORE PREDICTS DISABILITY IN AFRICAN CHILDREN WITH PLASMODIUM FALCIPARUM MALARIA

RAIMUND HELBOK*, SAADOU ISSIFOU, PIERRE B. MATSIEGUI, PETER LACKNER, MICHEL A. MISSINOU, DAVY KOMBILA, WOLFGANG DENT, ERICH SCHMUTZHARD, AND PETER G. KREMSNER
Department of Neurology, University of Innsbruck, Innsbruck, Austria; Medical Research Unit of the Albert Schweitzer Hospital, Lambaréné, Gabon; Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany

In this prospective study, we assessed the simplified multi-organ dysfunction score (sMODS) in 485 consecutive African children, hospitalized with Plasmodium falciparum malaria. Children were grouped according to their ability to walk unaided (Group 1, N = 414), sit unaided (Group 2, N = 63), or inability of both (Group 3, N = 8) before contracting malaria. The sMODS on admission to hospital was highly correlated with prolonged disease duration in Groups 1 and 2 (Spearman r = 0.79 and r = 0.78, respectively). A sMODS of ≥ 16 was indicative for prolonged disease duration in Group 1 (> 48 hours of inability to walk, sensitivity of 87%, specificity of 82%) and Group 2 (> 24 hours of inability to sit, sensitivity of 100%, and specificity of 78%.). The simplified MODS is a simple and sensitive measure merit of severity of illness in children with P. falciparum malaria and allows early prognostic evaluation.

Received December 9, 2005. Accepted for publication April 1, 2006.

Acknowledgments: We are indebted to all the patients who took part in the study and to their parents or guardians whose dedication to collaborate made this study possible.

Financial support: This project was supported by Medical University Innsbruck Project P5190-013-011-Intensiv.

* Address correspondence to Raimund Helbok, Clinical Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. E-mail: Raimund.Helbok{at}uklibk.ac.at

Authors’ addresses: Raimund Helbok, Clinical Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria, E-mail: Raimund.Helbok{at}uklibk.ac.at. Saadou Issifou, Albert Schweitzer Hospital Research Unit, Lambaréné, Gabun, E-mail: issifou{at}lambarene.mimcom.net. Pierre Blaisse Matsiegui, Albert Schweitzer Hospital Research Unit Lambaréné, Gabun. Peter Lackner, Clinical Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria, E-mail: Peter.Lackner{at}uibk.ac.at. Michel Missinou and Davy Kombila, Albert Schweitzer Hospital Research Unit, Lambaréné, Gabun. Wolfgang Dent, Clinical Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria, E-mail: Wolfgang.Dent{at}macnews.de. Erich Schmutzhard, Department of Intensive Care Unit and the Department of Neurology Clinical Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria, E-mail: Erich.Schmutzhard{at}uibk.ac.at. Peter G. Kremsner, Institute for Tropical Medicine, University Hospital Tübingen, Wilhelmstrasse 27, 72074 Tübingen, Germany, E-mail: Peter.Kremsner{at}uni-tuebingen.de.




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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.