Legros et al identified risk factors associated with mortality in patients with Plasmodium falciparum imported into France. These can help identify patients who may require closer monitoring. The authors are from multiple hospitals across France.
Clinical risk factors:
(1) age (risk very high if > 60 years; risk high if > 45 years)
(2) European origin (either traveler or expatriate)
(3) travel to East Africa
(4) failure to use chemoprophylaxis
Laboratory risk factors:
(1) hemoglobin <= 8.0 g/dL
(2) platelet count <= 50,000 per µL (very high if < 25,000 per µL)
(3) leukocyte count > 15,000 per µL (moderate if > 10,000 per µL)
(4) percent parasitemia (very high if > 20%; high if > 10%; moderate if > 5%)
Additional factors:
(1) male gender
(2) delay in diagnosis
Risk Factor |
Odds Ratio |
parasitemia > 20% |
117 |
platelet count < 10,000 per µL |
89 |
platelet count 10,000 - 24,999 per µL |
70 |
age > 60 years |
35 |
parasitemia 10.1 - 20% |
29 |
leukocyte count > 15,000 per µL |
24 |
age 45 to 60 years |
15 |
parasitemia 5.1 - 10% |
12 |
platelet count 25,000 - 50,000 per µL |
11 |
European origin |
10 |
travel to East Africa |
8 |
age 31 to 44 years |
5 |
hemoglobin <= 8 g/dL |
5 |
leukocyte count 10,001 to 15,000 per µL |
5 |
delay in diagnosis 4 to 14 days |
3 |
failure to use chemoprophylaxis |
2 |
male gender |
2 |
Specialty: Infectious Diseases