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Severe malarial anemia is associated with long-term neurocognitive impairment

Paul Bangirana1, Robert O Opoka2, Michael J Boivin3

  • 1Department of Psychiatry, and.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 29, 2014
PubMed

Insights

Severe malaria anemia (SMA) and cerebral malaria (CM) in young children (<5 years) can cause long-term cognitive deficits. CM also impacts attention and memory, while SMA primarily affects cognitive ability, highlighting malaria

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroscience

Background:

  • Cerebral malaria (CM) is known to cause neurocognitive impairment in older children.
  • No prior prospective studies evaluated neurocognitive outcomes in children under 5 with CM or severe malarial anemia (SMA).
  • Severe malarial anemia (SMA) affects millions of children annually and is a significant public health concern.

Purpose of the Study:

  • To prospectively assess neurocognitive impairment in children under 5 years old with CM and SMA.
  • To compare the long-term neurocognitive outcomes of CM and SMA in young children.
  • To identify the specific cognitive domains affected by each severe malaria subtype.

Main Methods:

  • Children under 5 with CM (n=80) or SMA (n=86) were recruited in Uganda.
  • Neurocognitive assessments (cognitive ability, attention, associative memory) were conducted at 1 week, 6 months, and 12 months post-discharge.
  • Outcomes were compared to 61 healthy community children (CC) using mixed linear models, adjusted for covariates.

Main Results:

  • At 12 months, children with CM showed significantly lower scores than CC in cognitive ability, attention, and associative memory.
  • Children with SMA had significantly lower cognitive ability scores than CC, but not attention or associative memory.
  • No significant difference in cognitive ability scores was observed between children with CM and SMA.

Conclusions:

  • In children under 5, SMA is linked to long-term cognitive ability impairment.
  • CM is associated with additional impairments in attention and associative memory.
  • SMA represents a substantial contributor to long-term neurocognitive deficits in sub-Saharan African children.
Abstract

Keywords:
cerebral malariacognitiveimpairmentsevere malarial anemia

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