Volume 68, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The usual criteria for severe malaria are not always sufficient to identify patients who subsequently develop this disease. The multi-organ dysfunction score (MODS) was assessed in 22 patients with uncomplicated malaria to test its usefulness in discriminating different severity levels. The MODS on admission was highly correlated with the baseline concentration of tumor necrosis factor-α (r = 0.83, < 0.001) and the duration of symptoms after admission (r = 0.54, = 0.01). The MODS was also correlated with parasite count (r = 0.52, = 0.014), parasite clearance time (r = 0.54, = 0.009), and fever clearance time (r = 0.58, = 0.005). The above correlations remained significant after controlling for the initial parasitemia ( = 0.03 and 0.005). The MODS is simple and easy to apply and needs a recording time of less than three minutes. Thus, this score might provide a quantitative approach for determining severity in malaria.


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  1. Silamut K, White NJ, 1993. Relation of stage parasite development in the peripheral blood to prognosis in severe falciparum malaria. Trans R Soc Trop Med Hyg 87 : 436–443.
    [Google Scholar]
  2. Grau MF, Taylor TE, Molneux ME, Wirima JJ, Vassalli P, Hommel M, Lambert PH, 1989. Tumor necrosis factor and disease severity in children with falciparum malaria. N Engl J Med 320 : 1586–1591.
    [Google Scholar]
  3. Kern P, Hemmer CJ, van Damme J, Gruss HJ, Dietrich M, 1989. Elevated tumor necrosis factor alpha and interleukin-6 serum levels as marker for complicated Plasmodium falciparum malaria. Am J Med 87 : 139–143.
    [Google Scholar]
  4. Kwiatkowski D, Hill AVS, Sambou I, Twumasi P, Castracane J, Manogue KR, Cerami A, Brewster DR, Greenwood BM, 1990. TNF concentrations in fatal cerebral, non-fatal cerebral and uncomplicated P. falciparum malaria. Lancet 336 : 1201–1204.
    [Google Scholar]
  5. Day NP, Hien TT, Schollaardt T, Loc PP, Chuong LV, Chau TT, Mai NT, Phu NH, Sinh DX, White NJ, Ho M, 1999. The prognostic and pathophysiologic role of pro- and anti-inflammatory cytokines in severe malaria. J Infect Dis 180 : 1288–1297.
    [Google Scholar]
  6. World Health Organization, 2000. Severe falciparum malaria. Trans R Soc Trop Med Hyg 94 : S1–S90.
    [Google Scholar]
  7. World Health Organization, Division of Control of Tropical Diseases, 1990. Severe and complicated malaria. Trans R Soc Trop Med Hyg 84 (Suppl 2) : 1S–65S.
    [Google Scholar]
  8. Weiler Th, Baldering HJ, Heinrichs W, Schmitz JE, 1997. Qualitätssicherung in der Intensivmedizin. Ergebnisse einer Multicenterstudie in Deutschland. Anasthesiol Intensivmed Notfallmed Schmerzther 32 : 372–375.
    [Google Scholar]
  9. Day NP, Pham TD, Phan TL, Dinh XS, Pham PL, Ly VC, Tran TH, Nguyen TH, Bethell DB, Ngyuan HP, Tran TH, White NJ, 1996. Clearance kinetics of parasites and pigment-containing leukocytes in severe malaria. Blood 88 : 4694–4700.
    [Google Scholar]
  10. Desakorn V, Silamut K, Angus B, Sahassananda D, Chotivanich K, Suntharasamai P, Simpson J, White NJ, 1997. Semi-quantitative measurement of Plasmodium falciparum antigen PfHRP2 in blood and plasma. Trans R Soc Trop Med Hyg 91 : 479–483.
    [Google Scholar]

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  • Received : 23 Jul 2002
  • Accepted : 05 Dec 2002

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