Cerebral Malaria: Mechanisms of Brain Injury and Strategies for Improved Neurocognitive Outcome

Idro, Richard; Marsh, Kevin; John, Chandy C.; Newton, Charles R.

doi:10.1203/pdr.0b013e3181eee738

Cited by 417 publications

(408 citation statements)

References 86 publications

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“…In endemic areas of sub-Saharan Africa, the frequency of seizure due to P. falciparum malaria is about 80% (White, 1999), with half of the children hospitalized with falciparum malaria reported to have seizures like symptoms (Idro et al, 2010). Epileptic seizures are the most frequent manifestation of central nervous system (CNS) involvement (Taratuto et al, 1997).…”

Section: Plasmodium Falciparum and Falciparum Malariamentioning

confidence: 99%

Epilepsy and tropical parasitic infections in Sub-Saharan Africa: a review

Mazigo

Morona

Kweka

et al. 2013

Tanzania J Hlth Res

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Several reports have suggested that the high prevalence of epilepsy in sub-Saharan Africa is associated with the high prevalence of parasitic infections affecting the central nervous system. Though epidemiological evidence suggests an association between parasitic infections and epilepsy, the biological causal relationship has not been fully demonstrated for many of these infections. The objective of this paper is to review the available epidemiological evidence on the links between parasitic infections and epilepsy, the pathogenesis and the current gap of knowledge indicating the areas requiring further research. Data for this review were identified and collected using manual and electronic search strategies of published and unpublished sources. In Sub-Saharan Africa, the epidemiology of epilepsy remains unclear and given the differing study designs, the results of available epidemiological studies are difficult to interpret and compare. Evidence from surveys reported a median prevalence of 1.5%. Co-infection of parasitic infections and epilepsy in sub-Saharan Africa are common, particularly in areas characterized by poor hygiene standards. There is an epidemiological link on the association between epilepsy and various parasitic infections. However, the biological causal relationship requires further investigation in adequately designed studies. In conclusion, although several epidemiological and case control studies indicate a relationship between parasitic agents and epilepsy in sub-Saharan Africa, there is a considerable gap of knowledge on the cause and magnitude of the association. Thus, there is an urgent need for systematic epidemiological studies to understand the burden of epilepsy in areas endemic due to preventable parasitic infections, to prove a causal relationship, and to understand the impact of controlling these parasitic diseases on reduction of the burden of epilepsy.___________________________________________________________________________________

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Section: Plasmodium Falciparum and Falciparum Malariamentioning

confidence: 99%

Epilepsy and tropical parasitic infections in Sub-Saharan Africa: a review

Mazigo

Morona

Kweka

et al. 2013

Tanzania J Hlth Res

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“…Infection may lead to neurodevelopmental impairment through direct CNS injury by the infectious pathogen or through pathways that may involve inflammation as 1 component, but may not be traditionally defined as inflammation. 40 …”

Section: Infections Inflammation and Neurodevelopmentmentioning

confidence: 99%

Executive Summary: Research Gaps at the Intersection of Pediatric Neurodevelopment, Nutrition, and Inflammation in Low-Resource Settings

et al. 2017

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“…48 Parasitic sequestration leads to a static blood flow, localized tissue hypoxia, acidosis, and inflammation, which results in venous congestion, raised ICP, altered consciousness, and convulsions. 49 Nevertheless, cerebral edema is not considered to be responsible for coma. 50 Cerebral autoregulation becomes disrupted in those with intracranial hypertension.…”

Section: Neurologicalmentioning

confidence: 99%

“…50 Cerebral autoregulation becomes disrupted in those with intracranial hypertension. 49 Seizures must be treated promptly with a benzodiazepine (e.g., midazolam or lorazepam), though prophylactic therapy is not recommended. Hypoglycemia must be excluded as a cause of the coma or altered mental status.…”

Section: Neurologicalmentioning

confidence: 99%

Perioperative considerations of the patient with malaria

Soltanifar

Carvalho

Sultan

2014

Can J Anesth/J Can Anesth

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Purpose Malaria is a life-threatening infectious disease caused by the Plasmodium parasite. Increased global travel has resulted in an escalation in the number of imported cases seen in developed countries. Patients with malaria may present for surgery in both endemic and nonendemic countries. This article reviews the perioperative considerations when managing patients with malaria. Source A literature review of anesthesia, perioperative care, and malaria-related articles was performed using the MEDLINE Ò , EMBASE TM , and Web of Science databases to identify relevant articles published in English during . Of the 303 articles matching the search criteria, 265 were excluded based on title and abstract. Eleven of the remaining 38 articles were relevant to anesthesia/perioperative care, and 27 articles were identified as having direct relevance to critical care medicine. Principal findings The majority of imported malaria cases are caused by the falciparum species, which is associated with the greatest degree of morbidity and mortality. Various organ systems may be impacted as a consequence of changes in the structure and function of parasitized erythrocytes. Preoperative assessment should focus on establishing the species of malaria, the severity of disease, assessing the degree of end-organ impairment, and initiating treatment of malaria prior to surgery. Intravenous artesunate is the treatment of choice for severe falciparum malaria. Quinine is a second-line agent but has a narrow therapeutic index and particularly hazardous side effects. Intraoperatively, attention should focus on fluid management, dynamics of cerebral blood flow, and avoidance of hypoglycemia. Postoperative care of severe cases should ideally take place in a critical care unit as there may be ongoing requirements for multi-organ support, including renal replacement therapy, ventilation, and/or inotropic support. The safety of neuraxial anesthesia has not been well studied in the setting of malaria. Conclusions Malaria remains one of the most devastating infectious diseases worldwide. Multiple organ systems can be impacted as a consequence of changes in structure and function of parasitized erythrocytes. Safe perioperative management requires a sound knowledge of all these potential system effects. RésuméObjectif Le paludisme est une maladie infectieuse possiblement fatale due au parasite Plasmodium. La multiplication des voyages à travers le monde a entraîné un accroissement du nombre de cas importés observés dans les pays développés. Les patients atteints de paludisme peuvent nécessiter une chirurgie, aussi bien dans les pays où la maladie est endémique que dans les autres. Cet article passe en revue les considérations périopératoires lors de la prise en charge de patients atteints de paludisme. Source Une revue de la littérature à la recherche d'articles d'anesthésie, de soins périopératoires et en Author contributions Daniel Soltanifar, Brendan Carvalho, and Pervez Sultan all made substantial contributions to the literature review, ...

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Cerebral Malaria: Mechanisms of Brain Injury and Strategies for Improved Neurocognitive Outcome

Cited by 417 publications

References 86 publications

Epilepsy and tropical parasitic infections in Sub-Saharan Africa: a review

Epilepsy and tropical parasitic infections in Sub-Saharan Africa: a review

Executive Summary: Research Gaps at the Intersection of Pediatric Neurodevelopment, Nutrition, and Inflammation in Low-Resource Settings

Perioperative considerations of the patient with malaria

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