Mishra et al reported the Malaria Score for Adults (MSA) which is based on organ failures. This can help to identify a patient who may benefit from more aggressive management. The authors are from Ispat General Hospital and Sushilavati Government Women's College in Orissa, India, and the University of Maryland.
Patient selection: symptomatic adult with falciparum malaria
Parameters:
(1) severe anemia (hemoglobin < 5 g/dL)
(2) acute renal failure (serum creatinine > 3 mg/dL)
(3) respiratory distress syndrome
(4) cerebral malaria (unrousable coma)
Parameters |
Findings |
Points |
severe anemia |
absent |
0 |
|
present |
1 |
acute renal failure |
absent |
0 |
|
present |
2 |
respiratory distress |
absent |
0 |
|
present |
3 |
cerebral malaria |
absent |
0 |
|
present |
4 |
total score =
= SUM(points for the 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the mortality.
Total Score |
Mortality |
0 to 2 |
2% |
3 or 4 |
10% |
5 or 6 |
40% |
7 to 10 |
90% |
Performance:
• The sensitivity was 90% and specificity 71%
• The positive predictive value was 94% when score >= 5.
Specialty: Infectious Diseases