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Cerebral malaria: A cause for severe neurological complications

<div><span style="font-family: helvetica;">As people across the globe prepare to take part in a wide range of activities to mark the World Malaria Day on April 25, cerebral malaria which forms part of the spectrum of this disease will be highlighted.  This illness is the most severe neurological complication of infection with plasmodium falciparum which is the most prevalent malaria parasite on the African continent and mostly affects children and pregnant women.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">According to data from the Centre for Disease Control and prevention (CDC), in Kenya, there are an estimated 6.7 million new clinical cases and 4,000 deaths each year resulting from the disease, and those living in malaria prone areas such as Nyanza, Western and Coastal regions are at high risk.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">This year’s theme will be “End Malaria For Good” and provides a common platform for countries to showcase their successes in malaria control and unify diverse initiatives in the changing global context. Malaria endemic countries have made incredible gains against malaria in the last decade, but sustaining them will take extra efforts until malaria is eliminated worldwide.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">Talking about cerebral malaria, Dr Jacob Shabani, Consultant Family Medicine Physician at Aga Khan University Hospital, explained, “Malaria is an infectious disease caused by the release of protozoan parasites into the bloodstream through a bite by a parasite-carrying Anopheles mosquito.  After an incubation period of one to four weeks, initial malaria symptoms begin to appear which include fever, headaches, vomiting, chills, and general malaise, similar to the effects of flu.”</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">“These symptoms are caused by the release of the parasites into the bloodstream and if patients are tested and treated quickly they recover relatively easily.  The ones not diagnosed immediately develop a more severe form of the disease known as cerebral malaria.  This is caused by parasite infected red blood cells in large numbers reaching the circulatory vessels of the brain.”</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">“The fast development of the parasite in the body organs may kill the patient in just a few hours.  The symptoms of this disease include fever, impaired consciousness, convulsion, a coma which may last three days and seizures in children.”</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">“With the passage of time, most people native to malaria endemic areas, who become infected with the  uncomplicated form of the disease over and over again, build up resistance because their bodies</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">develop an effective antibody defense mechanism.  Children under the age of six years, pregnant women and people who are not indigenous to areas where malaria is pervasive, and have not yet fostered this immunity by building up enough antibodies are left susceptible to the more severe manifestations of cerebral malaria.”</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">“Diagnosing cerebral malarial is challenging because its symptoms resemble other diseases such as meningitis.  Among the tests carried out are blood, spinal fluids from the spinal cord and retinopathy (abnormalities in the eyes retina).  Information on the patient’s visits to malaria prone areas such as Nyanza, Western and Coast regions of Kenya is important to the doctor.”</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">“Primary treatment involves the use of chemotherapy in the form of Quinine and Artemisinin which have a reputation as beneficial treatments.  Managing the symptoms is also difficult and some of the measures have disputable advantages. These are medications to reduce fever, seizure, agents to decrease intracranial pressure and anti-inflammatory which may have benefit,” explains Dr Shabani. </span></div>
 

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