Cerebral malaria and bacterial meningitis

Misra, Usha Kant; Kalita, Jayantee; Prabhakar, Sudesh; Chakravarty, Ambar; Kochar, Dhanpat Kumar; Nair, PP

doi:10.4103/0972-2327.83101

Cited by 26 publications

(48 citation statements)

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“…The term cerebral malaria was reserved for Blantyre coma score ≤ 2 corrected for no record of recent severe head trauma, neurological disease, or other causes of febrile encephalopathy such as meningitis (assessed by the examination of cerebrospinal fluid) [32]. Uncomplicated malaria (UM) was defined as being fully conscious with haemoglobin ≥8 g/dl and no signs of severity and/or evidence of vital organ dysfunction [23].…”

Section: Methodsmentioning

confidence: 99%

Epidemiological and clinical profile of paediatric malaria: a cross sectional study performed on febrile children in five epidemiological strata of malaria in Cameroon

Kwenti¹,

Kwenti²,

Latz³

et al. 2017

BMC Infect Dis

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BackgroundIn the wake of a decline in global malaria, it is imperative to describe the epidemiology of malaria in a country to inform control policies. The purpose of this study was to describe the epidemiological and clinical profile of paediatric malaria in five epidemiological strata of malaria in Cameroon including: the Sudano-sahelian (SS) strata, the High inland plateau (HIP) strata, the South Cameroonian Equatorial forest (SCEF) strata, the High western plateau (HWP) strata, and the Coastal (C) strata.MethodsThis study involved 1609 febrile children (≤15 years) recruited using reference hospitals in the five epidemiological strata. Baseline characteristics were determined; blood glucose level was measured by a glucometer, malaria parasitaemia was assessed by Giemsa microscopy, and complete blood count was performed using an automated hematology analyser. Severe malaria was assessed and categorized based on WHO criteria.ResultsAn overall prevalence of 15.0% (95% CI: 13.3–16.9) for malaria was observed in this study. Malaria prevalence was significantly higher in children between 60 and 119 months (p < 0.001) and in Limbe (C strata) (p < 0.001). The overall rate of severe malaria (SM) attack in this study was 29.3%; SM was significantly higher in children below 60 months (p < 0.046). Although not significant, the rate of SM was highest in Maroua (SS strata) and lowest in Limbe in the C strata. The main clinical phenotypes of SM were hyperparasitaemia, severe malaria anaemia and impaired consciousness. The majority (73.2%) of SM cases were in group 1 of the WHO classification of severe malaria (i.e. the most severe form). The malaria case-fatality rate was 5.8%; this was higher in Ngaoundere (HIP strata) (p = 0.034).ConclusionIn this study, malaria prevalence decreased steadily northward, from the C strata in the South to the SS strata in the North of Cameroon, meanwhile the mortality rate associated with malaria increased in the same direction. On the contrary, the rate of severe malaria attack was similar across the different epidemiological strata. Immunoepidemiological studies will be required to shed more light on the observed trends.

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Section: Methodsmentioning

confidence: 99%

Epidemiological and clinical profile of paediatric malaria: a cross sectional study performed on febrile children in five epidemiological strata of malaria in Cameroon

Kwenti¹,

Kwenti²,

Latz³

et al. 2017

BMC Infect Dis

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“…CM is a symmetric and diffuse, potentially reversible encephalopathy caused mainly by P. falciparum. [4][5]10 It is an error to considering that any cerebral clinical manifestation in a patient with malaria is defining the disease 3 The most agreed definition (Table 1) includes the confirmation of P. falciparum infection and the exclusion of other causes of encephalitis, 9 since neurological symptoms can be mimicked by metabolic acidosis, anemia or hypoglycemia. 2,10,11 CM is not a concept free of conflicts in the literature.…”

Section: Conceptmentioning

confidence: 99%

“…The first symptoms usually occur 10 to 15days after the bite and include as main manifestations: high fever (40ºC-40.5ºC), myalgias, headaches, sweating and other typical manifestations of a flu syndrome. [2][3]6 In children and immunosuppressed the first manifestations can occur the first 6 to 12 hours. 3 Hypothermia is a rare manifestation, but observable in cases of shock.…”

Section: Clinical Manifestations 142224mentioning

confidence: 99%

“…It is estimated that there are about 300 million cases and one million annual deaths attributable to it. [2][3][4][5] The growing concern for this disease, not only resides in endemic areas, but is increasingly a concern in non-endemic countries, due to the migratory flow and the ease of traveling. [6][7][8] Cerebral Malaria (CM) is the most severe 2,9 and frequent 4 complication caused by Plasmodium (P) falciparum infection.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral malaria

Valentim¹

2018

JNSK

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Malaria is one of the main public health problems in endemic areas, with 300 to 500million cases and 1 to 1.5million annual deaths. 4-5,11 It is the first cause of death, of parasitic origin in the entire world. 4 P. falciparum is responsible for 80% of fatal cases hospitalized in endemic areas 4 and neurological complications are found in 50% of children admitted to the hospital. 6 In 2013, an incidence of malaria was estimated to be around 198million cases worldwide and some 575,000 cases of CM were reported, with the African child population being the most affected, 11 with a mortality of 25-30%10. 12,000 cases are considered imported from Europe to Malaria, France being the country with the largest number, about 5,000 cases per year. 5 In one of the retrospective studies conducted in French intensive care centers, where 400 cases of imported severe malaria were received, a mortality of 10% was observed. 5 Imported malaria has an estimated mortality of 10-15%. 5 CM occurs in 2.4% of travelers with malaria to P. falciparum. 6,7 Etiology 1 Anopheles: The bite of the mosquito of the female Anopheles spp. Species infected with P. falciparum transmits the disease to the human being. 2,11 The importance of these vectors lies in being one of the objectives of the malaria control programs. 12 In the mosquito life cycle we distinguish 4 stages: egg, larva, chrysalis and adult. All these phases depend on temperature and nutritional factors, and there is a greater development if temperatures are high. 13 Plasmodium: Malaria is caused by a group of parasites belonging to the genus Plasmodium spp, 2,13 which are protozoa of the Sporozoa class, of the order Eucoccidiida and suborder Haemosporidiida. 13 There are more than 100 species, although only four of them are responsible for Malaria in the human: P. Ovale, P. Malariae, P. Falciparum and P. Vivax. 2,14 The latter two, being responsible for the majority of cases worldwide. 2,13 Within the species responsible for more complications, P. falciparum 4 stands out, with 1% of severe complications that culminated in multi-organ failure. 6,14 P. vivax is responsible for convulsions in children, and also for coma in children and adults. 6

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“…The ketone bodies accumulate and produce signs and symptoms seen in DKA such as weakness, nausea, vomiting, abdominal pain, fast respiration (Kussmaul breathing), decrease level of consciousness and coma [4,5]. These clinical features also mimic acute infections such as cerebral malaria, meningitis and pneumonia [6,7]. Therefore, misdiagnosis of DKA as infections is possible and probably more common in African than has been reported [1,8,9].…”

Section: Introductionmentioning

confidence: 99%