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Am. J. Trop. Med. Hyg., 75(6), 2006, pp. 1148-1150
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


ROLE OF VIRUSES IN KENYAN CHILDREN PRESENTING WITH ACUTE ENCEPHALOPATHY IN A MALARIA-ENDEMIC AREA

CHRISTIAN D. SCHUBART*, NEEMA MTURI, MARCEL G. H. M. BELD, PAULINE M. WERTHEIM, AND CHARLES R. J. C. NEWTON
Academical Medical Centre, University of Amsterdam, Department of Medical Microbiology, Laboratory of Clinical Virology, Amsterdam, The Netherlands; The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya; Neurosciences Unit, Institute of Child Health, The Wolfson Centre, Mecklenburgh Square, London, United Kingdom

 

ABSTRACT

In malaria-endemic areas, it is difficult to differentiate between cerebral malaria (CM), bacterial meningitis, and viral encephalitis. We examined the cerebrospinal fluid of 49 children who fulfilled the World Health Organization’s (WHO) definition of CM and in 47 encephalopathic children, without malaria, looking for viruses with polymerase chain reaction. In the children with CM, four (9%) had evidence of Herpes simplex virus 1 in the cerebrospinal fluid, whereas in the encephalopathy group without malaria, six (12%) were positive. A significant proportion of children who fulfil the WHO clinical definition of CM may have viral encephalitis.

Received May 5, 2006. Accepted for publication July 25, 2006.

Acknowledgments: We thank the technical staff of the microbiology laboratory department of the KEMRI/Wellcome Trust Research Unit and the Department of Clinical Virology of the Academic Medical Centre Amsterdam, especially Tony Kazungu, Brett Lowe, and Alex van Breda. Research support has been provided by Stichting Harald Quintus Bosz, Nationaal Epilepsie Fonds, Stichting Bekker-La Bastide-Fonds, Hersenstichting Nederland, Schuurman Schimmel-van Outeren Stichting, and Fonds van Beuningen van Heilsdingen. Professor CRJC Newton is funded by the Wellcome Trust (070114). None of the study sponsors had any influence in the study design, the collection of data, analysis, or interpretation of data.

* Address correspondence to Christian D. Schubart, Nicolaas Witsenstraat 13, 1017 ZE, Amsterdam, The Netherlands. E-mail: cdschubart{at}gmail.com

Authors’ addresses: Christian Schubart, Nicolaas Witsenstraat 13, 1017 ZE, Amsterdam, The Netherlands, Telephone: 31-20-4223376, E-mail: cdschubart{at}gmail.com. Neema Mturi, KEMRI/Wellcome Trust Collaborative Programme, PO Box 230, Kilifi 80108, Kenya, Telephone: 254-41-525043/525446, Fax: 254-41-522390. Marcel Beld, Academic Medical Center, Department of Clinical Virology, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands, Telephone: 31-20-5665472, Fax: 31-20-6974005, E-mail: m.beld{at}amc.uva.nl. Pauline Wertheim, Academic Medical Center, Department of Clinical Virology, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands, Telphone: 31-20-5665472, Fax: 31-20-6974005, E-mail: p.m.wertheim{at}amc.uva.nl. Charles Newton, KEMRI/Wellcome Trust Collaborative Programme, PO Box 230, Kilifi 80108, Kenya, Telephone: 254-41-525043/525446, Fax: 254-41-522390, E-mail: cnewton{at}kilifi.kemri-wellcome.org.




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