Rehabilitation for cognitive impairments after cerebral malaria in African children: strategies and limitations

Bangirana, Paul; Idro, Richard; John, Chandy C.; Boivin, Michael J.

doi:10.1111/j.1365-3156.2006.01685.x

Cited by 43 publications

(21 citation statements)

References 51 publications

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“…Though 'traditional' therapist centered or computer based cognitive retraining may indeed be beneficial, the feasibility of such interventions in resource limited settings (lack of trained staff, language restrictions, lack of equipment and unfamiliarity with technology) is questionable. In a recent review on cognitive rehabilitation of children with cerebral malaria, Bangirana et al [55] describes the place of standard or computer based cognitive rehabilitation, environmental enrichment, nutritional improvement, speech and physiotherapy in children with post malarial cognitive impairment. However apart from computer based cognitive rehabilitation, evidence for other measures in post malarial cognitive impairment is yet to be established.…”

Section: Methodsmentioning

confidence: 99%

The 'hidden' burden of malaria: cognitive impairment following infection

Fernando

Rodrigo

Rajapakse

2010

Malar J

118

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BackgroundThe burden of post-malaria cognitive impairment is often overlooked. Given the large number of infections occurring worldwide, the magnitude of the problem is likely to be substantial. The objectives of this paper are; (i) to assess the evidence on post malarial cognitive impairment or impact on school education; (ii) to assess the possible positive impact of malaria drug prophylaxis on cognition; and (iii) to suggest recommendations on minimizing the burden of post-malarial cognitive impairmentMethodsPUBMED and SCOPUS were searched for all articles with the key word 'Malaria' in the title field and 'cognitive impairment' in any field. Google Scholar was searched for the same keywords anywhere in the article. The search was restricted to articles published in English within the last 15 years (1995-2010). After filtering of abstracts from the initial search, 44 papers had research evidence on this topic.Results & DiscussionCognitive abilities and school performance were shown to be impaired in sub-groups of patients (with either cerebral malaria or uncomplicated malaria) when compared with healthy controls. Studies comparing cognitive functions before and after treatment for acute malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery. Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups. The implications of these findings are discussed.

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Section: Methodsmentioning

confidence: 99%

The 'hidden' burden of malaria: cognitive impairment following infection

Fernando

Rodrigo

Rajapakse

2010

Malar J

118

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“…Restricted rehabilitation services have been attributed to a dearth of appropriately qualified personnel [11–14] and an absence of professional organisations [2]. Reporting on provision in Ghana, Tinney et al [4] stated that there were no occupational therapists or physiatrists, very few speech and language therapists, prosthetists, orthotists and physical therapists, because of a lack of funding and limited government support.…”

Section: Introductionmentioning

confidence: 99%

Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Bunning¹,

Gona²,

Odera-Mung'ala³

et al. 2013

Disability and Rehabilitation

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Purpose: Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. Method: A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Results: Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. Conclusions: The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. ä Implications for RehabilitationThere needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed.

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“…Recent estimates put the number of children under five years in low income countries who fail to reach their full cognitive potential because of poverty, poor health and nutrition and deficient care at over 200 million [3]. In light of the above, interventions targeting the environment in which these children live have been suggested [2], [4], [5]. Examples of these interventions are improving child nutrition, early child education, providing a stimulating environment, parenting training and adult education [6], [7], [8], [9], [10].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Predictors of Cognition in Ugandan Children: Implications for Community Interventions

et al. 2009

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BackgroundSeveral interventions to improve cognition in at risk children have been suggested. Identification of key variables predicting cognition is necessary to guide these interventions. This study was conducted to identify these variables in Ugandan children and guide such interventions.MethodsA cohort of 89 healthy children (45 females) aged 5 to 12 years old were followed over 24 months and had cognitive tests measuring visual spatial processing, memory, attention and spatial learning administered at baseline, 6 months and 24 months. Nutritional status, child's educational level, maternal education, socioeconomic status and quality of the home environment were also measured at baseline. A multivariate, longitudinal model was then used to identify predictors of cognition over the 24 months.ResultsA higher child's education level was associated with better memory (p = 0.03), attention (p = 0.005) and spatial learning scores over the 24 months (p = 0.05); higher nutrition scores predicted better visual spatial processing (p = 0.002) and spatial learning scores (p = 0.008); and a higher home environment score predicted a better memory score (p = 0.03).ConclusionCognition in Ugandan children is predicted by child's education, nutritional status and the home environment. Community interventions to improve cognition may be effective if they target multiple socioeconomic variables.

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Rehabilitation for cognitive impairments after cerebral malaria in African children: strategies and limitations

Cited by 43 publications

References 51 publications

The 'hidden' burden of malaria: cognitive impairment following infection

The 'hidden' burden of malaria: cognitive impairment following infection

Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Socioeconomic Predictors of Cognition in Ugandan Children: Implications for Community Interventions

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