Table 2

Summary of articles with models predicting mortality in paediatric severe malaria

N	Study	Year	Period of participant recruitment	Country	Type of study	Sample size	Statistics used	Name of model	Method internal of validation	Age profiles	Sex profiles	Outcome predicted	Variables used	Diagnostic properties	External validation	Use in clinical settings
Mortality
1	Jaffar et al 21	1997	1992–1994	Gambia	Retrospective analysis of data from a randomised control trial	624	Logistic regression	None	None	1–9.5 years	Females—49%	Mortality in paediatric cerebral malaria	Cold periphery, deep coma and hypoglycaemia	Not done	None	NE
2	Molyneux et al 27	1989	January 1987 to June 1988	Malawi	Cohort	131	Univariable analysis	Bedside prognostic index	None	7 months to 10 years	Females—55.7%	Mortality in paediatric cerebral malaria	Blood glucose, parasitaemia, WBC count, age, coma score, absent corneal reflexes, decerebration, convulsions	Positive predictive value—83%, sensitivity—66%	None	NE
3	Conroy et al 16	2012	1997–2009	Malawi	Cohort	155	Logistic regression	None	Hosmer-Lemeshow goodness-of-fit test	8 months to 14 years	Females—54.4%	Mortality in patients with cerebral malaria	Age, Blantyre coma score, respiratory distress, severe anaemia, angiopoietin-1, angiopoietin-2 and sTie-2 levels	C-index of 0.79 (95% CI 0.72 to 0.84)	None	NE
4	Krishna et al 22	1994	1988–1989	Gambia	Cohort study	115	Logistic regression	None	Wald statistic and ROC analysis	18 months to 12 years	NC	Mortality in paediatric severe malaria	Coma score, whole blood lactate/glucose ratio, TNF level	Wald statistic: coma score (4.5), lactate/glucose ratio (8.36), TNF level (6.5)	None	NE
5	Marsh et al 23	1995	May 1989 to November 1991	Kenya	Cohort	1844	Logistic regression	None	None	Mean: 26 months	NC	Mortality in children with severe malaria	Impaired consciousness, respiratory distress, hypoglycemia, and jaundice	Predicted 92.2% of deaths	None	NE
6	Newton et al 28	2005	January 2001 to December 2003	Malawi, Kenya and Ghana	Cohort	14 605	Linear regression	None	AUROC	Mean age: 32–36 months	Females—53%–55%	Mortality in paediatric severe falciparum malaria	Deep breathing, Blantyre Coma Score, inability to sit, weight-for-age Z score, hypoglycaemia, base excess and lactate concentration	c-statistic 0.83–0.88 in the three sites: Blantyre (0.88), Kilifi (0.87) and Kumasi (0.83)	None	NE
7	Gérardin et al 32	2006	1 October 1997 to 31 March 1999	Senegal	Cohort	311	Logistic regression	PRISM (paediatric risk of mortality) AUC: 0.9240	Hosmer-Lemeshow χ² test	Median: 8 years (IQR: 5–11 years)	Females—40.5%	Mortality in children with falciparum malaria	Systolic blood pressure, temperature, mental status, heart rate, dilatation of pupils, pH, total CO₂, PCO₂, arterial PaO₂, serum glucose, potassium, urea, creatinine, white blood cells, prothrombin time, platelet count	AUROC for acute malaria: 0.89 (95% CI 0.85 to 0.92) and 0.86 (95% CI 0.81 to 0.90) for severe malaria	Yes	NE
8	Helbok et al 20	2009	December 2000 to May 2005	Gambia, Malawi, Kenya, Ghana, and Gabon	Cohort	23 890	Logistic regression	LODS (Lambaréné Organ Dysfunction Score)	Internal validation using Bonferroni correction	Mean: 30–38 months	Females—41%–47%	Mortality in children with severe falciparum malaria	Coma, prostration and deep breathing	AUROC: 0.80 (0.79 to 0.82)	Yes	NE
9	von Seidlein et al 30	2012	2005–2010	Gambia, Mozambique, Nigeria, Rwanda, Kenya, DRC, Tanzania, Ghana, Uganda	Retrospective analysis	5426	Logistic regression	None	ROC analysis	Median: 2.8 years (1.7, 4.3)	NC	Mortality in paediatric severe falciparum malaria	Base deficit, coma, convulsions, BUN and chronic illness	AUROC: 0.85 (95% CI 0.83 to 0.87)	None	NE
10	Conroy et al 31	2015	NC	Uganda	Cohort	1589	Logistic regression	SICK (Signs of Inflammation in Children that Kill) ³⁸—AUC*: 0.887 (sensitivity 84.1% specificity 82.2%)	Hosmer-Lemeshow goodness-of-fit	NC	Females—54.3%	Mortality in malaria	Altered consciousness, temperature, heart rate, respiratory rate, systolic blood pressure, capillary refill time and age	AUROC: 0.846	Yes	NE
								LODS57	Hosmer-Lemeshow goodness-of- fit	NC	Females—54.3%	Mortality in malaria	Prostration, coma (BCS) and deep breathing	AUROC: 0.898	Yes	NE
								PEDIA39—AUC*: 0.93 (95% CI 0.92 to 0.94)	Hosmer-Lemeshow goodness-of- fit	NC	Females—54.3%	Mortality in malaria	Kwashiokor†, jaundice, subcostal indrawing, prostration (±seizures) and wasting	AUROC: 0.896	Yes	NE

*Diagnostic properties of original model.
†Not used in present model.
AUROC, area under the receiver operating curve; BCS, Blantyre coma score; BUN, blood urea nitrogen; DRC, Democratic Republic of the Congo; NC, not clear; NE, no evidence; TNF, tissue necrotic factor; WBC, white blood cells.