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Cerebral malaria in children

R W Steele1, B Baffoe-Bonnie

  • 1Department of Pediatrics, Louisiana State University School of Medicine, New Orleans, USA.

The Pediatric Infectious Disease Journal
|April 1, 1995
PubMed
Summary
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Cerebral malaria in Ghanaian children presents with fever, seizures, and altered consciousness, especially in first-time infections. Young children face higher risks of severe disease, long-term effects, and mortality.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Tropical Medicine

Background:

  • Malaria remains a significant health challenge in West Africa.
  • Cerebral malaria, a severe form of the disease, disproportionately affects young children.
  • Understanding the clinical presentation and risk factors is crucial for effective management.

Purpose of the Study:

  • To describe the clinical characteristics of cerebral malaria in children admitted to a hospital in Ghana.
  • To identify risk factors associated with central nervous system involvement and poor outcomes.
  • To inform public health strategies for managing severe malaria in endemic regions.

Main Methods:

  • Retrospective chart review of 187 children admitted with cerebral malaria in 1993.
  • Analysis of clinical presentations, including fever, neurological status, and organomegaly.

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  • Statistical analysis to determine risk factors for severe disease and mortality.

    • Main Results:

    • Fever, sensorial depression, and convulsions were the most common symptoms in children with their first malaria episode.
    • Splenomegaly (50%), hepatomegaly, vomiting, and headache were also frequent.
    • Long-term sequelae occurred in 9% and mortality in 6% of cases.
    • Risk factors for CNS disease included no prior malaria history and high parasitemia.
    • Multiple seizures and prolonged altered consciousness predicted poor outcomes.

    Conclusions:

    • Young children experiencing their first malaria episode are vulnerable to severe cerebral malaria.
    • Prompt recognition and management of severe malaria symptoms are vital to reduce mortality and long-term complications.
    • Targeted interventions for high-risk groups are needed as malaria incidence rises in West Africa.