Delayed Neuropsychiatric Effects of Malaria in Ghana

Abstract

This study investigated the long-term emotional and cognitive effects of malaria infection in a sample of community resident nonmigratory Ghanaian adults, comparing 142 individuals with a documented history of clinical falciparum malaria and 30 controls without a lifetime medical diagnosis of malaria. Results were based on self-report inventory and interview-based approaches to assessment of emotional status as well as individual administration of the Mini-Mental State Examination. Our findings indicated the presence of an enduring, albeit subclinical, mixed anxiety-depression syndrome after medical recovery from falciparum malaria. There were, however, no significant neurocognitive deficits associated with malaria status on the objective screening instrument, nor were there reports of subjective attention, concentration, memory, or other cognitive complaints by self-report. Malaria may be a risk factor for psychiatric morbidity. We therefore recommend a search for effective malaria prevention and intervention strategies to avert the more serious clinical manifestations of mental disorder likely to evolve in this imminently lethal infectious disease.

Challenges in the Determination of Early Predictors of Cerebral Malaria: Lessons from the Human Disease and the Experimental Murine Models

“…In adults, the incidence of neurological and cognitive impairment is lesser than in children ( ! 5%), but the range of types of sequelae is much greater, including cranial nerve lesions, neuropathies, extrapyramidal disorders, focal epilepsy, poor dichotic listening, personality change, depression, and subclinical mixed anxiety-depression syndrome [112][113][114] .…”

A Brief Assessment of Learning for Orphaned and Abandoned Children in Low and Middle Income Countries

“…In previous studies of child intelligence and learning in LMIC, cognitive development after disease is a prevalent theme, with research exploring the effects of HIV/AIDS [28–31] and malaria [32–40] on the abilities and achievement of children in African countries. Investigators in these studies often use instruments developed in high income countries; and, for the most part, the strategies have been successful in demonstrating a hypothesized compromise in cognitive development due to disease effects on the central nervous system.…”

Neurologic Sequelae after Severe Falciparum Malaria in Adult Travelers

“…However, there are few reports of neurologic sequelae in adults [8, 9, 10]. Neuropsychiatric disorders following falciparum malaria were also described in 19 adults and 3 children in a large prospective Vietnamese study, and were referred to as a ‘post-malaria neurological syndrome’ [14].…”

“…The neuropsychological disorders may be explained by diffuse damage of the deep white matter tracts, possibly leading to dysfunction of the memory circuits and other cortical pathways. Dugbartey et al [9]found a persistent subclinical anxiety-depression syndrome after falciparum malaria in a group of 142 Ghanaian patients compared with a control group. Varney et al [8]reported personality changes and depression in Vietnam veterans who had had cerebral malaria in comparison with a control group who had not had malaria, 25 years after the war.…”

“…This usually concerns both children in endemic areas and travelers returning from the tropics. Neurologic sequelae in children are well recognized [2, 3, 4, 5, 6, 7], but few adult cases have been reported previously [8, 9, 10]. We describe the clinical course, magnetic resonance imaging (MRI) findings and management in six adult travelers with severe falciparum malaria resulting in neurologic sequelae.…”