Correlation of retinal haemorrhages with brain haemorrhages in children dying of cerebral malaria in Malawi

White, Valerie A.; Lewallen, Susan; Beare, Nicholas A. V.; Kayira, K; Carr, Richard; Taylor, Terrie E.

doi:10.1016/s0035-9203(01)90097-5

Cited by 87 publications

(74 citation statements)

References 7 publications

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“…17 The retinal changes tend to be associated with severe manifestations and probably relate to the correlated number of retinal hemorrhages to density of brain hemorrhages in children dying of cerebral malaria. 23 The mechanism of retinal hemorrhage is uncertain in P. vivax infection. Sequestration of parasitized RBCs and cytoadhesion with rosetting are key pathogenic processes in P. falciparum patients.…”

Section: Signs Severe Moderate Uncomplicated Totalmentioning

confidence: 99%

Retinopathy of vivax malaria in adults and its relation with severity parameters

Kochar

Kalra

et al. 2016

Pathogens and Global Health

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Malarial retinopathy is a set of retinal signs in severe malaria due to falciparum malaria. With increased recognition of severe manifestations of vivax malaria, a systematic study to evaluate retinal changes in vivax malaria could elaborate our knowledge about this neglected entity. This observational study included retinal examination of 104 adult patients (>14 years) with varying severity of vivax malaria admitted to a tertiary care center during peak seasons of 2012 and 2013. Thirty-eight percent of severe cases had a retinal sign as compared to 6% of nonsevere cases (p < 0.01). No statistically significant effect of residence or age on the presence of retinopathy was noted. Females were found to be more prone to develop a retinal sign (p < 0.01). Presence of retinal signs was significantly associated with anemia and jaundice. No statistical association was noted for retinal signs to be present in either renal dysfunction or altered thrombocytes count. The most common signs were arteriovenous changes, present in eight cases (19%) of severe malaria and three cases (5%) of non-severe malaria. Retinal hemorrhage was present in five cases (12%) of severe malaria and no case of non-severe malaria. Both superficial and deep hemorrhages were seen including white-centered hemorrhages. Other signs included cotton wool spots, hard exudates, blurred disk margins with spontaneous venous pulsations and bilateral disk edema. A correlation between retinal signs and severity parameters was drawn from the study. This is the first systemic study to evaluate the retinal changes in vivax malaria. Larger prospective studies should be done for further knowledge regarding retinal changes in vivax malaria, especially severe disease. Apart from its clinical significance, it might lead to a better understanding of the pathogenesis of the systemic disease of vivax malaria.

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Section: Signs Severe Moderate Uncomplicated Totalmentioning

confidence: 99%

Retinopathy of vivax malaria in adults and its relation with severity parameters

Kochar

Kalra

et al. 2016

Pathogens and Global Health

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“…Retinal hemorrhages have been shown to correlate with brain hemorrhages on autopsy. 8 Vessel changes and discoloration have been associated with sequestration of pRBCs on histopathological examination, and retinal whitening has been shown to be caused by local tissue hypoxia. 9,10 Additionally, the presence and severity of malarial retinopathy (MR) is associated with parasite sequestration in the brain, prolonged coma, and death.…”

Section: Introductionmentioning

confidence: 99%

Clinical Comparison of Retinopathy-Positive and Retinopathy-Negative Cerebral Malaria

Villaverde¹,

Namazzi²,

Shabani³

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. Cerebral malaria (CM) is a severe and often lethal complication of falciparum malaria. A classic malaria retinopathy is seen in some (retinopathy-positive [RP]) children but not others (retinopathy-negative [RN]), and is associated with increased parasite sequestration. It is unclear whether RN CM is a severe nonmalarial illness with incidental parasitemia or a less severe form of the same malarial illness as RP CM. Understanding the clinical differences between RP and RN CM may help shed light on the pathophysiology of malarial retinopathy. We compared clinical history, physical examination, laboratory findings, and outcomes of RP (N = 167) and RN (N = 87) children admitted to Mulago Hospital, Kampala, Uganda. Compared with RN children, RP children presented with a longer history of illness, as well as physical examination and laboratory findings indicative of more severe disease and organ damage. The hospital course of RP children was complicated by longer coma duration and a greater transfusion burden than RN children. Mortality did not differ significantly between RP and RN children (14.4% versus 8.0%, P = 0.14). Further, severity of retinal hemorrhage correlated with the majority of variables that differed between RP and RN children. The data suggest that RP and RN CM may reflect the spectrum of illness in CM, and that RN CM could be an earlier, less severe form of disease.

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“…Studies on CM models show disorganized alignment of tight junctions between adjacent cells, increased vessel permeability, and increased transcytosis of molecules across the endothelium, though the mechanism is not fully understood [93,94]. The most striking example of BBB disruption is the presence of hemorrhage, which has been noted in the white matter in fatal CM [95][96][97]. Any disruption in the white matter might affect brain nuclei development which will in a long term appreciably affect mental functioning.…”

Section: Effect Of Mip On Fetal Neurodevelopmentmentioning

confidence: 99%

Effects of Malaria in Pregnancy (MiP) on Pregnancy Development and its Outcome: a Critical Review

Djabanor¹,

Quansah²,

DuBois³

2017

J App Biol Biotech

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Malaria is the most important tropical parasitic infection in humans all over the world, and very common in developing countries especially in the tropical zones. The protozoan parasites Plasmodium falciparum, P. vivax, P. malariae and P. ovaleare transmitted through the bite of sporozoite-infected female Anopheles mosquitoes to cause malaria in humans. Malaria in pregnancy (MiP) is a clinical situation in which a pregnant woman is infected with Plasmodium parasite resulting in malaria. MiP is detrimental to both the pregnant woman and her fetus, and it remains as one of the major causes of infant mortality in malaria endemic regions especially in Sub-Saharan Africa. It causes several histopathological changes within the placenta and umbilical cord which manifest in several clinical symptoms. It is one of the key contributors to preterm delivery, low birth weight, intrauterine growth retardation (IUGR), miscarriage, intrauterine death, poor neurodevelopment and immunosuppression in infants. Most distinct systemic proinflammatory responses in pregnancy are characteristics of severe malaria, and excessive activation of the immune system is central to the pathophysiology of placental malaria. There is extensive research on VAR2CSA and its contribution to placental sequestration. Currently, VAR2CSA protein is being made into pregnancy malaria specific vaccines for non-immune mothers to reduce placental malaria infection. This review summarizes the evidences, currently known clinically significant manifestations and the ultimate effect of MiP on pregnancy development.

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Correlation of retinal haemorrhages with brain haemorrhages in children dying of cerebral malaria in Malawi

Cited by 87 publications

References 7 publications

Retinopathy of vivax malaria in adults and its relation with severity parameters

Retinopathy of vivax malaria in adults and its relation with severity parameters

Clinical Comparison of Retinopathy-Positive and Retinopathy-Negative Cerebral Malaria

Effects of Malaria in Pregnancy (MiP) on Pregnancy Development and its Outcome: a Critical Review

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