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Table 1 WHO guideline for complicated malaria

From: Molecular basis of human cerebral malaria development

Clinical features
- Impaired consciousness: Glasgow Coma Scale <11 in adults or Blantyre coma score <3 in children
- Prostration
- Multiple convulsion: >2 episodes within 24 h
- Respiratory distress
- Pulmonary edema: radiologically confirmed or oxygen saturation <92 % in room air with a respiratory rate >30/min
- Significant bleeding: including recurrent or prolonged bleeding from the nose, gums, and venipuncture sites; hematemesis or melena
- Shock
Laboratory findings
- Metabolic acidosis: plasma bicarbonate <15 mmol/L or venous plasma lactate ≥5 mmol/L
- Hypoglycemia: blood glucose <2.2 mmol/L or 40 mg/dL
- Severe malarial anemia: Hb <5 g/dL, Hct ≤15 % in children (<12 years of age) with parasite >10,000/μL; Hb <7 g/dL, Hct ≤20 % in adults with parasite >10,000/μL
- Renal impairment: plasma or serum creatinine >265 μmol/L (3 mg/dL) or blood urea >20 mmol/L
- Jaundice: plasma or serum bilirubin >50 μmol/L (3 mg/dL) with parasite count >10,000/μL
- Hyperparasitemia: P. falciparum parasitemia >10 %