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Severe malaria anemia linked to neurocognitive impairment in young children
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Children younger than 5 years who have severe malarial anemia are at risk for long-term impairment in cognitive ability, according to researchers from Makerere University in Kampala, Uganda.
In addition, cerebral malaria is associated with additional risks, including impairment in the areas of attention and associative memory.
“These findings provide strong further rationale for malaria elimination programs, as they indicate that eliminating malaria has the potential to significantly decrease the burden of neurocognitive impairment in children in sub-Saharan Africa,” the researchers wrote in Clinical Infectious Diseases.
The study included children with cerebral malaria or severe malarial anemia and community children aged 18 months to 5 years. All of the children underwent a medical history and physical examination, as well as cognitive assessments such as the Mullen Scales of Early Learning, the Color Object Association Test and the Early Childhood Vigilance Test.
From November 2008 to January 2012, 80 children with cerebral malaria, 86 children with severe malarial anemia and 61 community children underwent cognitive testing at baseline, 6 and 12 months. At the 12-month follow-up, children with cerebral malaria had lower age-adjusted z scores than community children for cognitive ability, attention and associative memory. Children with severe malarial anemia had lower adjusted z scores for overall cognitive ability and a trend toward lower scores for attention, but no difference in associative memory compared with community children. There was no difference in cognitive scores between children with cerebral malaria and children with severe malarial anemia.
“Further study is required to determine the mechanisms by which cerebral malaria and severe malarial anemia lead to neurocognitive impairment, as this knowledge could lead to adjunctive neuroprotective therapy for children with severe malaria and decrease the long-term neurocognitive sequelae of severe malaria,” the researchers wrote.
Disclosure: The researchers report no financial disclosures.
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