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Global Health Matters

May - June, 2008  |  Volume 7, Issue 3

Cognitive Deficits Linked to Cerebral Malaria in Children

New research conducted in part with Fogarty support indicates that cerebral malaria (CM) increases by almost four times the risk that sub-Saharan children will have cognitive deficits, compared to children without any form of malaria.

Lead author Dr. Chandy C. John of the University of Minnesota Medical School, writes in Pediatrics that this study provides the first evidence from a prospective study that "CM may be a major cause of cognitive impairment" in children in the region. Previous research had found similar results based on retrospective studies.

More than 750,000 African children every year contract cerebral malaria, and more than 200,000 may suffer from residual neurological harm.

The study followed children age 5-12 at Mulago Hospital in Kampala, Uganda. Some had cerebral malaria, some had uncomplicated malaria (UM) and the largest cohort were not infected by malaria at all.

After two years of follow-up testing, 26.3 percent of the CM children compared to 12.5 percent of the UM children had cognitive deficits. Malaria-free children, by contrast, had deficits in 7.6 percent of cases.

"Deficits in children with cerebral malaria were primarily in the area of attention," the study says. "After adjustment for age, gender, nutrition, home environment and school level, children with cerebral malaria had a 3.67-fold increased risk for a cognitive deficit compared with community children."

The previous studies had followed subjects for six months after admission. This one followed the cohort for two years.

Cerebral Malaria in Children Is Associated With Long-term Cognitive Impairment. Chandy C. John, MD, Paul Bangirana, MS, Justus Byarugab, MMec, Robert O. Opoka, MMed, Richard Idro, MMed, Anne M. Jurek, PhD, Baolin Wu, PhD and Michael J. Boivin, PhD, MPH. Pediatrics. Published online June 9, 2008 (doi:10.1542/peds.2007-3709)

http://pediatrics.aappublications.org/papbyrecent.shtml.