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  • Scientists closer to predicting cerebral malaria


Scientists have taken a step towards more accurately predicting which malaria patients will go on to develop severe cerebral malaria, which could ultimately save patients' lives.

But health experts warn that improved diagnosis will do little to save people's lives without ensuring that patients receive medical care as soon as possible.

Infection with the malaria parasite ― Plasmodium falciparum ― can lead to a wide range of symptoms, from mild to severe.

Cerebral malaria ― a severe form of the disease ― is characterised by coma and convulsions. 25 to 40 per cent of malaria patients go on to develop cerebral malaria, which is fatal in up to half of sufferers.

Until now it has been difficult to determine which patients would develop cerebral malaria.

The study, led by Maryvonne Kombila from the University of Health Sciences in Gabon, examined 350 children under the age of five admitted to two hospitals in Gabon suffering from various forms of malaria between 1996 and 1999.

In collaboration with researchers from the Pasteur Institute and the National Centre for Scientific Research in France, the group found that 90 per cent of children who developed cerebral malaria had an antibody to a specific protein found in the brain in their blood.

Further research is being carried out to see if this was a cause, or a result, of the infection.

Sylviane Pied, of the malaria immunophysiology group at the Pasteur Institute, said, "In the field, a test allowing us to predict that a patient is susceptible to developing cerebral malaria would considerably improve patient care on admission."

Blaise Ayivi, head of paediatrics at the academic hospital at the University of Cotonou in Bénin ― a high-risk malaria region ― welcomed the research.

"This kind of research is always interesting to a clinician because it allows for action to be taken," he said.

But he cautioned against high expectations, noting that the research's usefulness has yet to be proven.

Alexandre Hountondji, of the Bénin Public Health Department, notes that research into prognostic tests is only effective if medical treatment is available early in the disease.

In Benin and a number of other West African countries, many children are only brought to hospitals in the last stages of cerebral malaria.

The results of the study were published last month (25 April) in the online journal PLoS ONE.

Link to full paper in PloS ONE

Reference: PLoS ONE doi: 10.1371/journal.pone.0000389.g006 (2007)

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