Seasonal Differences in Retinopathy-Negative versus Retinopathy-Positive Cerebral Malaria

Douglas G. Postels Department of Neurology and Ophthalmology, Michigan State University, International Neurologic and Psychiatric Epidemiology Program, East Lansing, Michigan; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Michigan State University, East Lansing, Michigan; University of Malawi College of Medicine, Blantyre Malaria Project, Blantyre, Malawi; Departments of Internal Medicine, Emergency Medicine, and International Medicine, Michigan State University, East Lansing, Michigan

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Gretchen L. Birbeck Department of Neurology and Ophthalmology, Michigan State University, International Neurologic and Psychiatric Epidemiology Program, East Lansing, Michigan; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Michigan State University, East Lansing, Michigan; University of Malawi College of Medicine, Blantyre Malaria Project, Blantyre, Malawi; Departments of Internal Medicine, Emergency Medicine, and International Medicine, Michigan State University, East Lansing, Michigan

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Clarissa Valim Department of Neurology and Ophthalmology, Michigan State University, International Neurologic and Psychiatric Epidemiology Program, East Lansing, Michigan; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Michigan State University, East Lansing, Michigan; University of Malawi College of Medicine, Blantyre Malaria Project, Blantyre, Malawi; Departments of Internal Medicine, Emergency Medicine, and International Medicine, Michigan State University, East Lansing, Michigan

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Kara M. Mannor Department of Neurology and Ophthalmology, Michigan State University, International Neurologic and Psychiatric Epidemiology Program, East Lansing, Michigan; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Michigan State University, East Lansing, Michigan; University of Malawi College of Medicine, Blantyre Malaria Project, Blantyre, Malawi; Departments of Internal Medicine, Emergency Medicine, and International Medicine, Michigan State University, East Lansing, Michigan

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Terrie E. Taylor Department of Neurology and Ophthalmology, Michigan State University, International Neurologic and Psychiatric Epidemiology Program, East Lansing, Michigan; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Michigan State University, East Lansing, Michigan; University of Malawi College of Medicine, Blantyre Malaria Project, Blantyre, Malawi; Departments of Internal Medicine, Emergency Medicine, and International Medicine, Michigan State University, East Lansing, Michigan

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Children with traditionally defined cerebral malaria (CM) can be subcategorized by the presence or absence of malaria retinopathy. We retrospectively reviewed the seasonal pattern of retinopathy status in patients admitted with CM in Blantyre, Malawi from 1997 to 2010. The proportion of children with CM who were retinopathy-positive was significantly greater during the peak seasonal rains when the community incidence of uncomplicated malaria is higher. This finding supports the hypothesis that retinopathy-negative and retinopathy-positive CM categories have different underlying etiologies.

Author Notes

* Address correspondence to Douglas G. Postels, International Neurologic and Psychiatric Epidemiology Program, Michigan State University, 909 Fee Road, 324 West Fee Hall, East Lansing, MI 48824. E-mail: douglas.postels@ht.msu.edu

Financial support: This work was supported by National Institutes of Health Grant 5R01AI34969-14 (to T.E.T.) and Wellcome Trust Grant 074125/Z/04/Z.

Authors' addresses: Douglas G. Postels and Gretchen L. Birbeck, International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, MI, E-mails: douglas.postels@ht.msu.edu and Gretchen.birbeck@ht.msu.edu. Clarissa Valim, Department of Immunology and Infectious Disease, Harvard School of Public Health, Boston, MA, E-mail: cvalim@hsph.harvard.edu. Kara M. Mannor, Department of Epidemiology, Michigan State University, East Lansing, MI, E-mail: mannorka@msu.edu. Terrie E. Taylor, Departments of Internal Medicine, Emergency Medicine, and International Medicine, Michigan State University, East Lansing, MI, E-mail: ttmalawi@msu.edu.

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