Neuro-developmental Impairment in Malaria - post from Nate Herr (PL2)

Posted on behalf of Nate Herr (PL2)

I've alluded to some of the pediatric clinical research and collaboration happening here in Kampala, it's really quite extensive and thorough.  I'll do my best to summarize.

Malaria has long been a common disease in the equatorial tropics.  It has a spectrum of severity, depending on the type of malaria one is infected with and the age and health of the person infected.  The most severe form of malaria is cerebral malaria which involves a patient in coma and is fatal if the malaria is not treated.  This is thought to be from the parasitized red blood cells sequestering in the blood flow to the brain or due to inflammation, the answer is not yet clear.

Earlier, the same collaboration group with UMN and Mulago Hospital, studied and compared two types of severe malaria.  One that I mentioned, Cerebral Malaria, and Severe Malaria with Anemia.  They followed the children through their illness and after they went home.  They did continued EEGs tracking seizures, neuropsych and cognition testing and found that children with anemia and no initial brain involvement with their malaria still had deficits and disability down the road.  These disabilities are a big problem in Uganda and sub-saharan Africa and already the research group here is studying to see if rehab programs can help children regain their abilities.

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What is about to start is a broader look at children with milder forms of malaria to see if they also have disability from it.  In this study, blood tests will also be done to look for clues as to what is actually causing it.  Home visits and clinic visits will again follow the children after their initial illness.

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Ahmed, Denis (our two medical officers with the study) and Dr. Postels

Our Ugandan Medical Officers are a critical part of this.  We held a training session today with Dr Doug Postels, our Michigan State collaborator.  He lectured on the neuro exam then afterwards the medical officers practiced, asked questions, and gave much needed feedback on the forms and documentation that we've been editing and creating these last weeks.

Every day I'm learning another piece of what it takes to get good information to answer good questions for the betterment child health care.  Nothing is ever simple and straightforward and the best insight comes from looking at the problem from all angles-- with medicine being only one of the angles.