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Serum levels of reactive nitrogen intermediates (RNI; nitrate plus nitrite) were measured in 92 patients with cerebral malaria in the Madang Province of Papua New Guinea. RNI levels were compared to disease severity and clinical outcome, and correlated with both the depth of coma on admission and its duration. Median levels were higher among children with deeper coma than among those with lighter coma (35.6 microM vs. 16.7 microM; P = 0.008) and also among children with longer duration of coma (72 h; 59.3 microM vs. 19.3 microM; P = 0.004). RNI levels also correlated with clinical outcome, fatal cases having significantly higher RNI levels than survivors (41.2 microM vs. 18.5 microM; P = 0.014). Thus, high RNI levels are associated with indices of disease severity and may predict outcome in children with cerebral malaria. These data are consistent with the hypothesis that nitric oxide is involved in the pathogenesis of coma in human cerebral malaria.

Original publication

DOI

10.1016/s0035-9203(96)90243-6

Type

Journal article

Journal

Transactions of the Royal Society of Tropical Medicine and Hygiene

Publication Date

05/1996

Volume

90

Pages

270 - 273

Addresses

Department of Biochemistry and Molecular Biology, Australian National University.

Keywords

Humans, Parasitemia, Malaria, Cerebral, Coma, Hypoglycemia, Nitrates, Nitrites, Treatment Outcome, Severity of Illness Index, Child, Child, Preschool, Infant, Papua New Guinea, Female, Male