Pediatric Cerebral Malaria

• Published in: Current tropical medicine reports 2021-06, Vol.8 (2), p.69-80
• Main Authors: Guenther, Geoffrey, Muller, Daniel, Moyo, Dominic, Postels, Douglas
• Format: Article
• Language: English
• Subjects: Behavioral Sciences; Infectious Diseases; Medicine; Medicine & Public Health; Parasitology; Section Editor; Topical Collection on Vector Borne Diseases and Associated Diseases; Tropical Medicine; Vector Borne Diseases and Associated Diseases (A Krishnavajhala
• ISSN: 2196-3045; 2196-3045
• DOI: 10.1007/s40475-021-00227-4

Purpose of Review Malaria is the most important parasitic disease of humankind. Cerebral malaria is malaria’s deadliest clinical manifestation and has a profound public health impact in endemic areas. In Africa, it is primarily a disease of childhood. Here we review recent updates in research into cerebral malaria pathogenesis, clinical care, treatment, and prevention. Recent Findings Malaria incidence is declining world-wide, though most of the decreases occurred prior to 2014. Clinically, highly increased brain volume on magnetic resonance imaging is strongly associated with mortality in children with cerebral malaria. Understanding which pathophysiological changes are responsible for these magnetic resonance imaging findings may lead to better design of clinical trials of targeted interventions that could lead to reductions in both mortality and neurological morbidity in cerebral malaria survivors. Prevention strategies, including vaccination, hold great promise to decrease the disease’s public health impact. Summary As science better understands the key pathophysiological steps between malaria infection, coma, and adverse outcomes, rational design of clinical trials of adjunctive therapies targeting key steps in the disease process will be possible. In the meantime, prevention strategies, including design and testing of candidate vaccines, must continue.