Clinical characteristics and outcomes associated with IWMDR in children with cerebral malariaa
| IWMDR+ | IWMDR− | OR | 95% CI | P Value | |
|---|---|---|---|---|---|
| Clinical characteristics | |||||
| Admission temperature (°C) | 38.9 ± 1.1 | 38.8 ± 1.2 | 1.11 | 0.87–1.42 | .40 |
| Plasma lactic acid levels (mmol/L) | 5.4 ± 3.6 | 6.9 ± 4.5 | 0.91 | 0.85–0.98 | .02 |
| Systolic blood pressure (mm Hg) | 41.2 ± 214.7 | 74.9 ± 137.6 | 1.00 | 0.99–1.00 | .14 |
| HIV status | 5 (9.6%) | 32 (16.3%) | 0.55 | 0.20–1.48 | .23 |
| Reported preadmission seizure | 53 (89.8%) | 171 (83.0%) | 1.80 | 0.72–4.52 | .21 |
| Plasma glucose level (mmol/L) | 6.4 ± 2.1 | 6.7 ± 3.6 | 0.97 | 0.89–1.06 | .49 |
| Plasma HRP-II levels | 10.2 ± 10.2 | 10.8 ± 10.1 | 0.99 | 0.96–1.02 | .67 |
| Received anticonvulsant at admission | 35 (57.4%) | 148 (71.2%) | 0.55 | 0.30–0.98 | .04 |
| Admission Blantyre coma scale score | 1.4 ± 0.6 | 1.3 ± 0.6 | 1.44 | 0.90–2.31 | .13 |
| Admission white blood cell count × 10−9/L | 10.5 ± 7.9 | 11.3 ± 7.9 | 0.98 | 0.95–1.03 | .51 |
| Platelet count × 10−9/L | 56 ± 60 | 59 ± 64 | 1.00 | 1.00–1.00 | .81 |
| EEG characteristics | |||||
| Average voltage (μV) | 128.9 ± 50.7 | 104.5 ± 53.5 | 1.01 | 1.00–1.02 | .02 |
| Maximum voltage (μV) | 251.1 ± 75.8 | 219.4 ± 88.5 | 1.00 | 0.99–1.01 | .06 |
| Sleep architecture | 20 (55.6%) | 66 (55.5%) | 1.00 | 0.47–2.13 | .99 |
| Dominant rhythm frequency (Hz) | 2.3 ± 0.9 | 2.4 ± 1.7 | NA | NA | .56 |
| Variability | 24 (66.7%) | 69 (58.0%) | 1.45 | 0.66–3.17 | .35 |
| Reactivity | 20 (58.8%) | 45 (40.5%) | 2.10 | 0.96–4.58 | .06 |
| General slowing | 35 (97.2%) | 105 (90.5%) | 3.67 | 0.46–29.4 | .22 |
| Paradoxic reactivity | 10 (50%) | 17 (37.0%) | 1.70 | 0.59–4.93 | .32 |
| Asymmetry | 7 (19.4%) | 34 (28.8%) | 0.60 | 0.24–1.49 | .27 |
| Outcomes | |||||
| Overall coma duration (hrs) | 47.5 ± 25.3 | 74.8 ± 43.9 | 0.98 | 0.97–0.99 | <.001 |
| Full recovery | 55 (90.2%) | 148 (71.2%) | 3.70 | 1.50–9.10 | .004 |
| Survival with sequelae | 5 (8.2%) | 27 (13.0%) | 0.60 | 0.22–1.63 | .32 |
| Death | 1 (1.6%) | 33 (15.9%) | 0.09 | 0.01–0.67 | .02 |
Note:—HRP-II indicates histidine-rich protein, a marker of parasite burden; IWMDR+, subjects with purely subcortical white matter abnormalities, excluding those with cortical DWI abnormalities and those with basal ganglia DWI abnormalities; IWMDR−, those who did not meet criteria for IWMDR+; NA, not applicable.
↵a Values are No. (%) or means.