THE BURDEN OF THE NEUROCOGNITIVE IMPAIRMENT ASSOCIATED WITH PLASMODIUM FALCIPARUM MALARIA IN SUB.docx
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THE BURDEN OF THE NEUROCOGNITIVE IMPAIRMENT ASSOCIATED WITH PLASMODIUM FALCIPARUM
MALARIA IN SUB-SAHARAN AFRICA
Malaria causes significant morbidity in terms of neurologic and cognitive impairment.
Plasmodium falciparum is responsible for almost all the mortality from malaria and is the only species
that appears to directly affect the central nervous system (CNS) causing neurologic deficits and cognitive
sequelae1 and epilepsy.
Plasmodium neurologic deficits
Literature search To identify the spectrum and frequency of neurocognitive impairment associated
with P. falciparum malaria
Definition of neurocognitive sequelae
neurocognitive sequelae are defined as impairment of neurologic or cognitive function
The neurologic impairment consists of loss of function in motor, including coordination, speech, vision,
and hearing domains and epilepsy
Estimating the frequency of neurocognitive sequelae.
Population at risk.
In 2000, 557 million people living in areas of sub-Saharan Africa climatically suitable for malaria
children at risk of developing cerebral malaria (CM), we used estimates of annualized CM from 1191-96
CM risk - 219,441 person-years exposure to risk among children resident within the hospital’s catchment
area between 0 and 9 years old
???: Although the rates of CM varied considerably between settings with the highest rates in areas of
low-to-moderate malaria transmission and the lowest rates in areas of intense malaria transmission.
The case fatalities of CM, even under optimal management conditions, are high.
Hospital admission surviving cases of CM and expose to risk of sequelae
Do not reach hospital mortality increases
hospitalized CM cases since 1990, the estimated median case-fatality rate was 17.0% surviving (0-9
years old = 0.874/1,000/year and 0.975/1,000/year.)
the total numbers of at-risk CM survivors is likely to be between 59,344 and 66,203 each year.
neurocognitive impairment in any infections with P. falciparum ranging from asymptomatic parasitemia
to consequences of severe disease.
Infection with P. falciparum.
study in Yemen demonstrated that parasitemic children performed worse than non-parasitemic children
in fine motor tasks, but not in cognitive tests.
chemoprophylaxis in Sri Lankan school children, chloroquine prophylaxis improved the scholastic
performance during a malaria transmission season.
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