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The usual criteria for severe malaria are not always sufficient to identify patients who subsequently develop this disease. The multi-organ dysfunction score (MODS) was assessed in 22 patients with uncomplicated Plasmodium falciparum malaria to test its usefulness in discriminating different severity levels. The MODS on admission was highly correlated with the baseline concentration of tumor necrosis factor-
(r = 0.83, P < 0.001) and the duration of symptoms after admission (r = 0.54, P = 0.01). The MODS was also correlated with parasite count (r = 0.52, P = 0.014), parasite clearance time (r = 0.54, P = 0.009), and fever clearance time (r = 0.58, P = 0.005). The above correlations remained significant after controlling for the initial parasitemia (P = 0.03 and 0.005). The MODS is simple and easy to apply and needs a recording time of less than three minutes. Thus, this score might provide a quantitative approach for determining severity in Plasmodium falciparum malaria.
Received July 23, 2002. Accepted for publication December 5, 2002.
Acknowledgments: We are indebted to Professor Rachanee Udomsangpetch and Dr. Yupaporn Wattanagoon for their support, contributions, and helpful critical review of the manuscript, the nurses of Bangkok Hospital for Tropical Diseases, whose dedication to excellence in both patient care and research made this study possible, and all patients who took part in this study.
Financial support: This study was supported by a grant from Mahidol University (Bangkok, Thailand) and the Department of Neurology, University Innsbruck (Innsbruck Austria) and by the National Institutes of Health grant ROI AI-51310.
Authors’ addresses: R. Helbok, W. Dent, and E. Schmutzhard, Department of Neurology, University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. M. Nacher, S. Treeprasertsuk, S. Krudsood, P. Wilairatana, and S. Looareesuwan, Faculty of Tropical Medicine, Mahidol University, Hospital for Tropical Diseases, 420/6 Ratchavithi Road, 10400 Bangkok, Thailand.
Reprint requests: R. Helbok, Department of Neurology, University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria, Fax: 43-512-504-4243, E-mail: raimund_helbok{at}yahoo.com
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