A study published in the Lancet Global Health has examined the relative influence of CNS infections and malaria parasites in the blood of seriously ill children in Malawi.
Scientists at LSTM, the University of Liverpool and the College of Medicine, Malawi have shown that viral brain infections may be a more important killer in African children than was previously thought.
The team looked at the role of viral infections in children that presented in a coma, and found that more than one quarter of patients had a virus in their brain.
The study included children who had malaria parasites in their blood, which previously may have been taken as the primary cause for the coma.
Dr Brian Faragher of LSTM, completed the statistical analysis used in the study along with Mavuto Mukaka of the Malawi-Liverpool-Wellcome Trust Clinical Programme (MLW). Dr Faragher said: “The statistical analysis carried out by myself and Mavuto contributed considerably to unravelling the relative influences of the central nervous system (CNS) infection and the parasitemia, on a child that presented in a coma, which otherwise would have been solely attributed to malaria.”
Lead author of the study, Professor Tom Solomon, from the Institute of Infection and Global Health said: “We have known for a long time that finding malaria parasites in the blood of a sick child does not always mean parasite is the cause.
“Many children living in villages in Malawi have blood full of parasites, apparently doing little harm, but ours was the first study to really look carefully for viral brain infections.
“We found that 32% of children with CNS infections had the malaria parasite, 21% of which died. We detected 12 different viruses, such as rabies, mumps, and human herpes, but significantly it was those with dual infection that went on to develop more severe symptoms, such as seizures.”
The study showed that children who had both malaria parasites in the blood and a virus in the brain tended to be most severely affected and most likely to die.
Viral CNS infections in children from a malaria-endemic area of Malawi: a prospective cohort study
Macpherson Mallewa PhD,Prof Pam Vallely PhD,Brian Faragher PhD,Dan Banda MSc,Paul Klapper PhD,Mavuto Mukaka MSc,Harriet Khofi Cert Nur Midwif,Paul Pensulo Dip Cli Med,Prof Terrie Taylor DO,Prof Malcolm Molyneux MD,Prof Tom Solomon PhD
The Lancet Global Health - 1 September 2013 ( Vol. 1, Issue 3, Pages e153-e160 )