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Table 1 A priori criteria for classifying cause of death

From: Mortality attributable to Plasmodium vivaxmalaria: a clinical audit from Papua, Indonesia

Category

Category description

Clinical criteria

1

Pure vivax malaria the primary cause of death

Potential mechanisms include: coma, extreme anaemia (haemoglobin <3 g/dL), respiratory distress not associated with evidence of sepsisa, acidosis if associated with severe anaemia or splenic rupture

2

Pure vivax malaria likely to have been a major contributor to death

Alternative cause(s) more likely to have led to death but vivax malaria a major contributor through one of the following mechanisms: haemoglobin <7 g/dL, respiratory distress not associated with evidence of bacterial sepsisa, acidosis if associated with haemoglobin <7 g/dL, splenic rupture, decreased consciousness or malnutritionb with two or more documented episodes of vivax malaria in the last year

3

Pure vivax malaria likely to have been a minor contributor to death

Alternative cause(s) more likely to have led to death but vivax malaria a minor contributor through one of the following mechanisms: fever, tachycardia or anaemia (haemoglobin between 7 g/dL and the lower limit of normal)

4

Pure vivax malaria unlikely to have contributed to death

No clear direct pathophysiological mechanism by which vivax malaria could have exacerbated or contributed to the primary cause(s) of death

  1. aSepsis conservatively attributed to bacterial co-infection. Evidence of sepsis defined as consolidation on chest X-ray or any deviation in white cell count from the age-adjusted normal range (birth; 20,000-40,000/mm3, 1 week; 5,000-21,000/mm3, 2 weeks; 5,000-20,000/mm3, 3 months to 12 months; 5,000-15,000/mm3, 1 year to 5 years; 5,000-12,000/mm3, greater than 5 years; 4,000-10,000/mm3).
  2. bMalnutrition defined as documented malnutrition in the notes or a weight-for-age Z-score less than -3, according to the WHO Child Growth Standards [19].