World Health Organization, 2016. World Malaria Report 2016. Geneva, Switzerland: World Health Organization.
Idro R, Marsh K, John CC, Newton CR, 2010. Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome. Pediatr Res 68: 267–274.
Birbeck GL, Molyneux ME, Kaplan PW, Seydel KB, Chimalizeni YF, Kawaza K, Taylor TE, 2010. Blantyre malaria project epilepsy study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: a prospective cohort study. Lancet Neurol 9: 1173–1181.
Idro R, Ndiritu M, Ogutu B, Mithwani S, Maitland K, Berkley J, Crawley J, Fegan G, Bauni E, Peshu N, 2007. Burden, features, and outcome of neurological involvement in acute falciparum malaria in Kenyan children. JAMA 297: 2232–2240.
World Health Organization, 2014. Severe malaria. Trop Med Int Health 19: 7–131.
Boivin MJ, Bangirana P, Byarugaba J, Opoka RO, Idro R, Jurek AM, John CC, 2007. Cognitive impairment after cerebral malaria in children: a prospective study. Pediatrics 119: e360–e366.
John CC, Bangirana P, Byarugaba J, Opoka RO, Idro R, Jurek AM, Wu B, Boivin MJ, 2008. Cerebral malaria in children is associated with long-term cognitive impairment. Pediatrics 122: e92–e99.
Holding PA, Stevenson J, Peshu N, Marsh K, 1999. Cognitive sequelae of severe malaria with impaired consciousness. Trans R Soc Trop Med Hyg 93: 529–534.
Kihara M, Carter JA, Holding PA, Vargha-Khadem F, Scott RC, Idro R, Fegan GW, de Haan M, Neville BG, Newton CR, 2009. Impaired everyday memory associated with encephalopathy of severe malaria: the role of seizures and hippocampal damage. Malar J 8: 273.
Boivin MJ, Vokhiwa M, Sikorskii A, Magen JG, Beare NA, 2014. Cerebral malaria retinopathy predictors of persisting neurocognitive outcomes in Malawian children. Pediatr Infect Dis J 33: 821–824.
Idro R, Kakooza-Mwesige A, Balyejjussa S, Mirembe G, Mugasha C, Tugumisirize J, Byarugaba J, 2010. Severe neurological sequelae and behaviour problems after cerebral malaria in Ugandan children. BMC Res Notes 3: 104.
Idro R, Carter JA, Fegan G, Neville BG, Newton CR, 2006. Risk factors for persisting neurological and cognitive impairments following cerebral malaria. Arch Dis Child 91: 142–148.
Bangirana P, Opoka RO, Boivin MJ, Idro R, Hodges JS, Romero RA, Shapiro E, John CC, 2014. Severe malarial anemia is associated with long-term neurocognitive impairment. Clin Infect Dis 59: 336–344.
Bangirana P, Opoka RO, Boivin MJ, Idro R, Hodges JS, John CC, 2016. Neurocognitive domains affected by cerebral malaria and severe malarial anemia in children. Learn Individ Differ 46: 38–44.
Taylor TE, Fu WJ, Carr RA, Whitten RO, Mueller JS, Fosiko NG, Lewallen S, Liomba NG, Molyneux ME, 2004. Differentiating the pathologies of cerebral malaria by postmortem parasite counts. Nat Med 10: 143–145.
Postels DG, Taylor TE, Molyneux M, Mannor K, Kaplan PW, Seydel KB, Chimalizeni YF, Kawaza K, Birbeck GL, 2012. Neurologic outcomes in retinopathy-negative cerebral malaria survivors. Neurology 79: 1268–1272.
Seydel KB, Kampondeni SD, Valim C, Potchen MJ, Milner DA, Muwalo FW, Birbeck GL, Bradley WG, Fox LL, Glover SJ, Hammond CA, Heyderman RS, Chilingulo CA, Molyneux ME, Taylor TE, 2015. Brain swelling and death in children with cerebral malaria. N Engl J Med 372: 1126–1137.
Gladstone M, Lancaster GA, Umar E, Nyirenda M, Kayira E, van den Broek NR, Smyth RL, 2010. The Malawi developmental assessment tool (MDAT): the creation, validation, and reliability of a tool to assess child development in rural African settings. PLoS Med 7: e1000273.
Bangirana P, Seggane-Musisi Allebeck P, Giordani B, John CC, Opoka OR, Byarugaba J, Ehnvall A, Boivin MJ, 2009. A preliminary examination of the construct validity of the KABC-II in Ugandan children with a history of cerebral malaria. Afr Health Sci 9: 186–192.
Kaufman AS, 2004. KABC-II: Kaufman Assessment Battery for Children. Bloomington, MN: NCS Pearson.
Boivin MJ, Gladstone MJ, Vokhiwa M, Birbeck GL, Magen JG, Page C, Semrud-Clikeman M, Kauye F, Taylor TE, 2011. Developmental outcomes in Malawian children with retinopathy-positive cerebral malaria. Trop Med Int Health 16: 263–271.
Gioia GA, Isquith PK, Guy SC, Kenworthy L, 2000. Behavior Rating Inventory of Executive Function: BRIEF. Odessa, FL: Psychological Assessment Resources.
Familiar I, Ruisenor-Escudero H, Giordani B, Bangirana P, Nakasujja N, Opoka R, Boivin M, 2015. Use of the behavior rating inventory of executive function and child behavior checklist in Ugandan children with HIV or a history of severe malaria. J Dev Behav Pediatr 36: 277–284.
Bangirana P, Musisi S, Boivin MJ, Ehnvall A, John CC, Bergemann TL, Allebeck P, 2011. Malaria with neurological involvement in Ugandan children: effect on cognitive ability, academic achievement and behaviour. Malar J 10: 334.
Bangirana P, John CC, Idro R, Opoka RO, Byarugaba J, Jurek AM, Boivin MJ, 2009. Socioeconomic predictors of cognition in Ugandan children: implications for community interventions. PLoS One 4: e7898.
Bergemann TL, Bangirana P, Boivin MJ, Connett JE, Giordani BJ, John CC, 2012. Statistical approaches to assess the effects of disease on neurocognitive function over time. J Biom Biostat (Suppl 7): 7310.
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Cerebral malaria (CM) is a common cause of death and disability among children in sub-Saharan Africa. Many prior studies of neuropsychiatric morbidity have been limited by a cross-sectional design or a short duration of follow-up. Most have included subjects who may have presented with coma due to a disease process other than CM. No studies have assessed the relationship between magnetic resonance imaging (MRI) findings and long-term outcomes. The Cognitive Outcomes and Psychiatric symptoms of retinopathy-positive CM (COPS) cohort is the first large (N = 221) prospectively recruited cohort of stringently defined cases of CM and hospital-based, age-matched, non-CM controls in whom cognitive and psychiatric outcomes are assessed with standardized measures semi-annually for up to 5 years. We report baseline characteristics of the cohort and outcomes at 1 month. At enrollment, CM cases were more likely to come from families with fewer socioeconomic resources and to have health characteristics that increase risk for malaria. In children younger than 5 years, cases were delayed in motor, language, and social development by approximately 6 months, compared with controls. More significant delays occurred in those with MRI abnormalities at the 1-month follow-up visit. There were no differences between cases and controls in inhibitory self-control, nor in cognitive function in children ≥ 5 years of age. The latter finding may be related to the smaller sample size, case-control imbalance in socioeconomic status, or the use of cognitive and behavioral assessments that are less culturally appropriate to this population. Continued follow-up will help determine predictors of long-term outcomes.
Financial support: This study received primary funding from the Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI.
Authors’ addresses: Rachel Brim, Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, and Department of Pediatrics, UCSF Benioff Children’s Hospital, San Francisco, CA, E-mail: rachel.brim@gmail.com. Sebastian Mboma and Sam Kampondeni, Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi, E-mails: sebastianmboma@gmail.com and s.kampo154@gmail.com. Margaret Semrud-Clikeman, Department of Pediatrics, University of Minnesota, Minneapolis, MN, E-mail: semrud@gmail.com. Jed Magen, Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, E-mail: jed.magen@hc.msu.edu. Terrie Taylor, Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, E-mail: ttmalawi@gmail.com. John Langfitt, Departments of Neurology and University of Rochester, Rochester, NY, E-mail: john_langfitt@urmc.rochester.edu.
World Health Organization, 2016. World Malaria Report 2016. Geneva, Switzerland: World Health Organization.
Idro R, Marsh K, John CC, Newton CR, 2010. Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome. Pediatr Res 68: 267–274.
Birbeck GL, Molyneux ME, Kaplan PW, Seydel KB, Chimalizeni YF, Kawaza K, Taylor TE, 2010. Blantyre malaria project epilepsy study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: a prospective cohort study. Lancet Neurol 9: 1173–1181.
Idro R, Ndiritu M, Ogutu B, Mithwani S, Maitland K, Berkley J, Crawley J, Fegan G, Bauni E, Peshu N, 2007. Burden, features, and outcome of neurological involvement in acute falciparum malaria in Kenyan children. JAMA 297: 2232–2240.
World Health Organization, 2014. Severe malaria. Trop Med Int Health 19: 7–131.
Boivin MJ, Bangirana P, Byarugaba J, Opoka RO, Idro R, Jurek AM, John CC, 2007. Cognitive impairment after cerebral malaria in children: a prospective study. Pediatrics 119: e360–e366.
John CC, Bangirana P, Byarugaba J, Opoka RO, Idro R, Jurek AM, Wu B, Boivin MJ, 2008. Cerebral malaria in children is associated with long-term cognitive impairment. Pediatrics 122: e92–e99.
Holding PA, Stevenson J, Peshu N, Marsh K, 1999. Cognitive sequelae of severe malaria with impaired consciousness. Trans R Soc Trop Med Hyg 93: 529–534.
Kihara M, Carter JA, Holding PA, Vargha-Khadem F, Scott RC, Idro R, Fegan GW, de Haan M, Neville BG, Newton CR, 2009. Impaired everyday memory associated with encephalopathy of severe malaria: the role of seizures and hippocampal damage. Malar J 8: 273.
Boivin MJ, Vokhiwa M, Sikorskii A, Magen JG, Beare NA, 2014. Cerebral malaria retinopathy predictors of persisting neurocognitive outcomes in Malawian children. Pediatr Infect Dis J 33: 821–824.
Idro R, Kakooza-Mwesige A, Balyejjussa S, Mirembe G, Mugasha C, Tugumisirize J, Byarugaba J, 2010. Severe neurological sequelae and behaviour problems after cerebral malaria in Ugandan children. BMC Res Notes 3: 104.
Idro R, Carter JA, Fegan G, Neville BG, Newton CR, 2006. Risk factors for persisting neurological and cognitive impairments following cerebral malaria. Arch Dis Child 91: 142–148.
Bangirana P, Opoka RO, Boivin MJ, Idro R, Hodges JS, Romero RA, Shapiro E, John CC, 2014. Severe malarial anemia is associated with long-term neurocognitive impairment. Clin Infect Dis 59: 336–344.
Bangirana P, Opoka RO, Boivin MJ, Idro R, Hodges JS, John CC, 2016. Neurocognitive domains affected by cerebral malaria and severe malarial anemia in children. Learn Individ Differ 46: 38–44.
Taylor TE, Fu WJ, Carr RA, Whitten RO, Mueller JS, Fosiko NG, Lewallen S, Liomba NG, Molyneux ME, 2004. Differentiating the pathologies of cerebral malaria by postmortem parasite counts. Nat Med 10: 143–145.
Postels DG, Taylor TE, Molyneux M, Mannor K, Kaplan PW, Seydel KB, Chimalizeni YF, Kawaza K, Birbeck GL, 2012. Neurologic outcomes in retinopathy-negative cerebral malaria survivors. Neurology 79: 1268–1272.
Seydel KB, Kampondeni SD, Valim C, Potchen MJ, Milner DA, Muwalo FW, Birbeck GL, Bradley WG, Fox LL, Glover SJ, Hammond CA, Heyderman RS, Chilingulo CA, Molyneux ME, Taylor TE, 2015. Brain swelling and death in children with cerebral malaria. N Engl J Med 372: 1126–1137.
Gladstone M, Lancaster GA, Umar E, Nyirenda M, Kayira E, van den Broek NR, Smyth RL, 2010. The Malawi developmental assessment tool (MDAT): the creation, validation, and reliability of a tool to assess child development in rural African settings. PLoS Med 7: e1000273.
Bangirana P, Seggane-Musisi Allebeck P, Giordani B, John CC, Opoka OR, Byarugaba J, Ehnvall A, Boivin MJ, 2009. A preliminary examination of the construct validity of the KABC-II in Ugandan children with a history of cerebral malaria. Afr Health Sci 9: 186–192.
Kaufman AS, 2004. KABC-II: Kaufman Assessment Battery for Children. Bloomington, MN: NCS Pearson.
Boivin MJ, Gladstone MJ, Vokhiwa M, Birbeck GL, Magen JG, Page C, Semrud-Clikeman M, Kauye F, Taylor TE, 2011. Developmental outcomes in Malawian children with retinopathy-positive cerebral malaria. Trop Med Int Health 16: 263–271.
Gioia GA, Isquith PK, Guy SC, Kenworthy L, 2000. Behavior Rating Inventory of Executive Function: BRIEF. Odessa, FL: Psychological Assessment Resources.
Familiar I, Ruisenor-Escudero H, Giordani B, Bangirana P, Nakasujja N, Opoka R, Boivin M, 2015. Use of the behavior rating inventory of executive function and child behavior checklist in Ugandan children with HIV or a history of severe malaria. J Dev Behav Pediatr 36: 277–284.
Bangirana P, Musisi S, Boivin MJ, Ehnvall A, John CC, Bergemann TL, Allebeck P, 2011. Malaria with neurological involvement in Ugandan children: effect on cognitive ability, academic achievement and behaviour. Malar J 10: 334.
Bangirana P, John CC, Idro R, Opoka RO, Byarugaba J, Jurek AM, Boivin MJ, 2009. Socioeconomic predictors of cognition in Ugandan children: implications for community interventions. PLoS One 4: e7898.
Bergemann TL, Bangirana P, Boivin MJ, Connett JE, Giordani BJ, John CC, 2012. Statistical approaches to assess the effects of disease on neurocognitive function over time. J Biom Biostat (Suppl 7): 7310.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 814 | 533 | 22 |
Full Text Views | 597 | 16 | 0 |
PDF Downloads | 164 | 23 | 0 |