Original articleCapillary refill time as an independent prognostic indicator in severe and complicated malaria
Section snippets
Study Subjects
The study was conducted in Komfo Anokye Teaching Hospital (KATH), a tertiary referral center in the city of Kumasi, Ghana, with 150 pediatric beds and 6000 annual pediatric admissions. It was carried out between 2001 and 2005, in parallel with the SMAC study, and its purpose was to investigate human genetic factors influencing severe malaria. Ethical approval was obtained from the Committee for Research, Publications, and Ethics of the School of Medical Sciences, Kwame Nkrumah University of
Results
Of 2446 patients studied (Figure 1), capillary refill time was assessed in 2342. Of these, 343 (14.6%) had a prolonged capillary refill time of <2 seconds (pCRT). Case fatality rate in the total group was 7.0%; among those with pCRT, it was 13.1%.
On univariate analysis, most of the clinical and laboratory parameters studied were significantly associated with fatality, including age, consciousness level, CRT, respiratory condition, hemoglobin, base excess, blood lactate, blood glucose, and
Discussion
The study group presented in the report was a subgroup of patients enrolled at a large tertiary referral centre in West Africa as part of the SMAC study.12 Multivariate analysis of patients presenting with the severe malaria complications of severe anemia, coma, and hyperlactatemia identified pCRT as an independent risk factor in addition to acidosis, coma, and respiratory distress. This indicates that pCRT was not associated with acidosis, coma, or respiratory distress specifically but
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Supported by the German Ministry of Education and Research (BMBF) through the National Genome Research Network (NGFN, NIE-S17T19).
T.A. is the Principal Investigator and D.A., S.A., E.A.A., S.B.N., K.O.K., A.O.Y.A., A.O.O., D.S., and J.S. are members of the Kumasi Severe Malaria in African Children (SMAC) Research Team.