From: Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness
 | Severe anaemia (Hb <5 g/dL) | Moderate anaemia (5 to <7 g/dL) | Mild anaemia (7 to <10 g/dL) | No anaemia (≥10 g/dL) | Total | P value |
---|---|---|---|---|---|---|
N (%)1 | 1,002 (33%) | 501 (16%) | 843 (27%) | 736 (24%) | 3,082 | Â |
General | Â | Â | Â | Â | Â | Â |
Age (months); median (IQR) | 25 (15, 42) | 23 (13, 36) | 19 (12, 34) | 24 (14, 45) | 24 (13, 38) | 0.02 |
Female | 439 (44%) | 245 (49%) | 367 (44%) | 364 (49%) | 1415 (46%) | 0.1 |
Weight-for-age z-score; median (IQR) | −1.6 | −1.6 | −1.5 | −1.3 | −1.5 | <0.001 |
(−2.5, –0.8) | (−2.6, –0.8) | (−2.4, –0.6) | (−2.2, −0.5) | (−2.4, −0.7) | ||
Axillary Temperature >39°C | 109 (11%) | 119 (24%) | 261 (31%) | 234 (32%) | 723 (24%) | <0.001 |
Respiratory | Â | Â | Â | Â | Â | Â |
Respiratory rate; mean (SD) | 56.1 (13.8) | 56.5 (14.5) | 60.3 (15.8) | 58.0 (16.6) | 57.8 (15.3) | <0.001 |
Respiratory distress | 845 (85%) | 410 (82%) | 694 (83%) | 574 (78%) | 2,523 (82%) | 0.001 |
Chest indrawing | 686 (69%) | 322 (64%) | 576 (68%) | 483 (66%) | 2,067 (67%) | 0.39 |
Deep breathing | 745 (75%) | 329 (66%) | 485 (58%) | 424 (58%) | 1,983 (65%) | <0.001 |
Oxygen saturation ≤90% | 260 (28%) | 107 (22%) | 187 (23%) | 195 (27%) | 749 (25%) | 0.36 |
Cardiovascular | Â | Â | Â | Â | Â | Â |
Weak radial pulse | 298 (29%) | 113 (23%) | 139 (16%) | 107 (15%) | 657 (21%) | <0.001 |
Lower limb temperature gradient2 | 661 (66%) | 295 (59%) | 467 (55%) | 394 (53%) | 1,883 (59%) | <0.001 |
Capillary refill time (3 or more seconds) | 573 (57%) | 115 (23%) | 80 (9%) | 50 (7%) | 818 (27%) | <0.001 |
Severe tachycardia3 | 616 (62%) | 377 (75%) | 623 (74%) | 544 (74%) | 2,160 (70%) | <0.001 |
Bradycardia | 18 (2%) | 3 (<1%) | 6 (<1%) | 8 (1%) | 35 (1%) | 0.11 |
Systolic blood pressure; median (IQR) | 88 (81, 96) | 93 (86, 101) | 94 (86, 102) | 98 (89, 106) | 93 (85, 101) | <0.001 |
Moderate hypotension4 | 100 (10%) | 25 (5%) | 43 (5%) | 19 (3%) | 187 (6%) | <0.001 |
Hypothermia (temperature <36°C) | 98 (10%) | 24 (5%) | 27 (3%) | 41 (6%) | 190 (6%) | <0.001 |
Dehydration (sunken eyes or reduced skin turgor) | 105 (11%) | 46 (9%) | 51 (6%) | 34 (5%) | 236 (8%) | <0.001 |
Anaemia | Â | Â | Â | Â | Â | Â |
Severe pallor (pale mucous membranes) | 989 (99%) | 381 (77%) | 167 (20%) | 38 (5%) | 1,575 (51%) | <0.001 |
Haemoglobinuria (history of dark urine) | 282 (28%) | 62 (12%) | 32 (4%) | 9 (1%) | 385 (13%) | <0.001 |
Clinical jaundice | 584 (58%) | 200 (40%) | 155 (18%) | 35 (5%) | 974 (32%) | <0.001 |
Neurological | Â | Â | Â | Â | Â | Â |
Prostrate5 | 726 (73%) | 328 (66%) | 466 (55%) | 387 (53%) | 1,907 (62%) | <0.001 |
Coma6 | 129 (13%) | 89 (18%) | 142 (17%) | 98 (13%) | 458 (15%) | 0.55 |
Convulsions in this illness | 264 (27%) | 212 (42%) | 358 (42%) | 320 (44%) | 1,154 (37%) | <0.001 |
Laboratory tests | Â | Â | Â | Â | Â | Â |
Positive malaria parasitaemia7 | 593 (59%) | 377 (75%) | 462 (55%) | 317 (43%) | 1,749 (57%) | <0.001 |
Hyperparasitaemia8 | 34/592 (6%) | 41/308 (13%) | 42/569 (7%) | 32/504 (6%) | 149/1,973 (8%) | 0.86 |
Glucose <2.5Â mmol/L | 52 (5%) | 28 (6%) | 31 (4%) | 23 (3%) | 134 (5%) | 0.02 |
Lactate ≥5 mmol/L | 672 (70%) | 218 (45%) | 184 (23%) | 75 (11%) | 1,149 (39%) | <0.001 |
Base deficit >8 | 392/632 (62%) | 189/329 (58%) | 254/554 (45%) | 239/539 (44%) | 1,074/2,054 (52%) | <0.001 |
Severe acidaemia (pH <7.2) | 97/635 (15%) | 38/291 (12%) | 48/556 (9%) | 30/511 (6%) | 213/2,061 (10%) | 0.82 |
Hyperkalaemia (>6.5Â mmol/L) | 83/630 (13%) | 41/330 (12%) | 54/559 (10%) | 28/536 (5%) | 206/2,055 (10%) | <0.001 |
HIV antibody positive | 17/790 (2%) | 25/390 (6%) | 36/666 (5%) | 31/615 (5%) | 109/2,461 (4%) | 0.008 |
Positive blood culture | 25/234 (11%) | 32/179 (18%) | 36/341 (11%) | 35/317 (10%) | 128/1,071 (12%) | 0.52 |