Epelboin et al reported a score for distinguishing malaria from dengue fever in an endemic region for both infections. The authors are Centre Hospitalier Andree Rosemon, University of French West Indies and French Guiana, Hopital Pitie-Salpetriere, Universite Montpellier, and the Institut Pasteur de Guyane.
Patient selection: febrile patient in a region endemic for malaria and dengue fever
Parameters:
(1) heart rate in beats per minute
(2) serum C-reactive protein in mg/L
(3) age in years
(4) platelet count in 10^9/L
(5) hematocrit in percent
(6) sex
Parameter
Finding
Points
heart rate
<= 90 beats per minute
0
> 90 beats per minute
1
serum CRP
<= 5 mg/L
0
> 5 mg/L
9
age
<= 15 years
0
> 15 years
1
platelet count
>= 100 * 10^9/L
0
< 100 * 10^9/L
2
hematocrit
>= 36%
0
< 36%
1
sex
female
0
male
1
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• A score < 10 is associated with a very low risk for malaria.
Performance:
• The score had a sensitivity of 99.5% and specificity of 41%.
The serum C-reactive protein alone can identify a patient in whom malaria is unlikely. Only 1 in 205 patients (0.5%) had a serum CRP <= 5 mg/L.
To read more or access our algorithms and calculators, please log in or register.
