One child dies every minute because of malaria and, in most cases, malaria-infected children die because of the swelling of the brain, suggest the findings of a new study that could pave the way to improved treatments.
In a new study published in the New England Journal of Medicine on March 19, Terrie Taylor from the Michigan State University, together with colleagues, discovered what causes the death of children with cerebral malaria, the most lethal type of the mosquito-borne disease.
Malaria is caused by a parasite transmitted by mosquitoes and is a major cause of death in the tropics. In 2013, there were 198 million cases of malaria globally. Of these 500,000 were fatal, killing mostly children. What makes battling the disease challenging is that there is no vaccine available for it. Although drugs can prevent infection and treat it, malaria remains deadly particularly among children.
Cerebral malaria involves the brain and may lead to coma and death. Between 15 and 25 percent of African children who contracted this particular type of malaria die of the disease. Those who manage to survive could also become deaf or blind or suffer from learning disabilities.
The researchers performed MRI scans on 168 children suffering from cerebral malaria. Of these, 25 children died, 84 percent of whom had severe swelling. Only 27 percent of the survivors, on the other hand, had severe swelling. Taylor said that the kids stopped breathing because the swelling compresses the respiratory center in the brain stem.
"Increased brain volume was seen in children who died from cerebral malaria but was uncommon in those who did not die from the disease, a finding that suggests that raised intracranial pressure may contribute to a fatal outcome," the researchers reported.
They also said that using ventilators could potentially save some of the affected children by maintaining their breathing when the swelling gets worse, a condition that could last for a few days.
"The next step is to identify what's causing the swelling and then develop treatments targeting those causes. It's also possible that using ventilators to keep the children breathing until the swelling subsides might save lives, but ventilators are few and far between in Africa at the moment," Taylor said.
Although certain drugs such as steroids and mannitol could also help with the swelling of the brain, Taylor said that studies are still needed to confirm this.
Photo: US Army Africa | Flickr
