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Updates in central nervous system malaria: literature review and considerations

Andrea Marino1,2, Dalida Angela Bivona1, Paolo Bonacci1

  • 1Department of Biomedical and Biotechnological Sciences.

Current Opinion in Infectious Diseases
|June 6, 2022
PubMed
Abstract

Insights

Cerebral malaria (CM), a severe Plasmodium falciparum complication, causes significant mortality and long-term effects, particularly in children. Current diagnostics and treatments, including artesunate, are improving, but research into CM pathogenesis is ongoing.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Pediatrics

Background:

  • Cerebral malaria (CM) is a severe complication of Plasmodium falciparum infection, associated with high morbidity and mortality, especially in children.
  • The pathogenesis of CM is not fully understood, though P. falciparum endothelium interactions are a key area of investigation.
  • Clinical manifestations of CM have been increasingly differentiated between adult and pediatric populations.

Purpose of the Study:

  • To review current understanding of cerebral malaria (CM) pathogenesis.
  • To outline diagnostic and therapeutic advancements in managing CM.
  • To highlight the challenges and ongoing research in pediatric CM.

Main Methods:

  • Review of recent literature on Plasmodium falciparum and cerebral malaria.
  • Analysis of diagnostic techniques including blood smears, PCR, LAMP, and biomarker identification.
  • Evaluation of therapeutic strategies, focusing on artesunate and management of cerebral complications.

Main Results:

  • While CM pathogenesis remains under investigation, theories focus on P. falciparum-endothelium interactions.
  • Diagnostic capabilities have advanced beyond blood smears to include molecular testing and biomarkers.
  • Artesunate is the established gold standard treatment for CM, with supportive care for neurological complications.

Conclusions:

  • Effective management of CM relies on rapid diagnosis and appropriate treatment, with artesunate as the cornerstone.
  • Further research into CM pathogenesis is crucial for developing more targeted therapies.
  • Improved diagnostic and therapeutic approaches are vital for reducing the severe sequelae of CM, particularly in children.

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