Article Category:
Research Article

A Qualitative Method To Assess a History of Cerebral Malaria in Malian Children

Karim Traore Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Ali Thera Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Drissa Coulibaly Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Abdoulaye K. Koné Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Boureima Guindo Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Bourama Tangara Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Aichatou A. Diawara Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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Mark A. Travassos Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland

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Mahamadou A. Thera Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;

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DOI:
https://doi.org/10.4269/ajtmh.23-0564
Volume/Issue:
Volume 112: Issue 1
Page(s):
72–78
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ABSTRACT.

The investigation of factors associated with susceptibility to severe malaria is best achieved using case-control studies. The presence of a history of severe malaria in controls could affect the quality of their phenotype and study findings and hence should be rigorously determined. Here, we assessed the performance of a qualitative questionnaire to identify a history of cerebral malaria in controls in a case-control study of severe malaria in Mali. We evaluated the archived medical records of 220 children diagnosed with severe diseases at health care centers in rural and urban settings in Mali from 2018 to 2019. Parents of enrolled children were then identified and interviewed using a structured questionnaire by an investigator blinded to the diagnosis. The diagnosis derived from the interview was then compared with the diagnosis from the medical records as the reference diagnosis. The sensitivity and specificity of the questionnaire to detect cerebral malaria in history were, respectively, 84% and 76%. The questionnaire was concordant with the medical record diagnosis in 60% (95% CI: 50–71%) of cases. For other clinical phenotypes of malaria (severe malaria anemia, uncomplicated malaria, and severe malaria anemia concurrent with cerebral malaria), sensitivity and specificity ranged from 42% to 85% and 88% to 96%, respectively. Positive and negative predictive values were, respectively, 75% and 85%. The questionnaire demonstrated suitable sensitivity and specificity to identify cerebral malaria in a participant’s history. In sub-Saharan Africa, a region with suboptimal medical record archives, such a tool could be used in case-control studies of severe malaria to select controls.

Author Notes

Financial support: This work was supported by the National Institute of Allergy and Infectious Diseases of the NIH under award number R01AI099628 to M. A. Thera and by grants R01HL130750 and R01HL146377 from the National Heart, Lung, and Blood Institute to M. A. Travassos. This research program is part of the EDCTP2 program supported by the European Union. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Disclosures: The study protocol was evaluated and approved by the ethics committee of the Faculty of Medicine and Pharmacy of Mali prior to the selection of the medical records and the interviews. Individual written informed consent was obtained from each parent before the interview.

Current contact information: Karim Traore, Ali Thera, Drissa Coulibaly, Abdoulaye K. Koné, Boureima Guindo, Bourama Tangara, Aichatou A. Diawara, and Mahamadou A. Thera, Malaria Research and Training Center (MRTC), Faculty of Medicine and Odonto-Stomatology (FMOS), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, E-mails: karim@icermali.org, alithera@icermali.org, coulibalyd@icermali.org, fankone@icermali.org, bguindo@icermali.org, bmtangara@icermali.org, aicha215@yahoo.fr, and mthera@icermali.org. Mark A. Travassos, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, E-mail: mtravass@som.umaryland.edu.

Address correspondence to Mahamadou A. Thera, MRTC/FMOS, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali. E-mail: mthera@icermali.org
Copyright:
© American Society of Tropical Medicine and Hygiene 2025
Received:
21 Aug 2023
|
Accepted:
14 Jul 2024
|
Published Online:
12 Nov 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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