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Am. J. Trop. Med. Hyg., 71(2 suppl), 2004, pp. 64-70
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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THE BURDEN OF THE NEUROCOGNITIVE IMPAIRMENT ASSOCIATED WITH PLASMODIUM FALCIPARUM MALARIA IN SUB-SAHARAN AFRICA

VICTOR MUNG’ALA-ODERA, ROBERT W. SNOW, AND CHARLES R. J. C. NEWTON
Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute, Kilifi, Kenya; Kenya Medical Research Institute-Wellcome Trust Collaborative Program, Nairobi, Kenya; Centre for Tropical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; Neurosciences Unit, Institute of Child Health, University of London, The Wolfson Center, London, United Kingdom

The burden of Plasmodium falciparum malaria has been estimated traditionally in terms of infections and mortality. Neurocognitive sequelae have recently been identified that add to the burden caused by this parasite. We have attempted to provide estimates of the neurocognitive burden based upon more recent estimates of the population at risk and a detailed review of published studies in sub-Saharan Africa. There is little data on which to estimate the burden, and considerable limitations in extracting the data from the published studies to provide these estimates. However, we estimate that at least 1,300–7,800 children will have neurologic sequelae following cerebral malaria in stable endemic areas per year. The figure is likely to be considerably higher, since these estimates do not include neurocognitive impairment following non-cerebral malaria in children or adults in stable endemic areas, or populations in low stable or epidemic areas.

Received August 21, 2003. Accepted for publication March 22, 2004.

Acknowledgments: This paper was published with the permission of the Director of the Kenya Medical Research Institute.

Financial support: This work was supported by grants to Robert W. Snow (no. 058992) and Charles R. J. C. Newton (no. 050533) as part of the Wellcome Trust Senior Research Fellows Program and the Kenyan Medical Research Institute.

Authors’ addresses: Victor Mung’ala-Odera, Center for Geographic Medicine-Coast, Kenya Medical Research Institute, PO Box 428, Kilifi, Kenya, E-mail: vodera{at}kilifi.mimcom.net. Robert W. Snow, Kenya Medical Research Institute-Wellcome Trust Collaborative Program, Nairobi, Kenya and Centre for Tropical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom. Charles R. J. C. Newton, Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute, PO Box 428, Kilifi, Kenya and Neurosciences Unit, Institute of Child Health, University of London, The Wolfson Center, Mecklenburgh Square, London WC1N 2AP, United Kingdom.




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