Neurodevelopmental impairments 1 year after cerebral malaria

John T. Langfitt, Michael P. McDermott, Rachel Brim, Sebastian Mboma, Michael J. Potchen, Sam D. Kampondeni, Karl B. Seydel, Margaret E Semrud-Clikeman, Terrie E. Taylor

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVES: Cerebral malaria (CM) causes significant mortality and morbidity in sub-Saharan African children. Reliable morbidity estimates are scarce because of methodological variability across studies. We describe the incidence, course, and severity of neurodevelopmental impairments in survivors of CM and the associated patient characteristics to inform epidemiologic estimates of malaria morbidity rates and prevention and treatment efforts. METHODS: We conducted an exposure-control study of 85 survivors of CM and 100 age-matched patients in a control group who were enrolled at hospital discharge and assessed after 1, 6, and 12 months using caregiver interviews and standardized developmental, cognitive, and behavioral measures. RESULTS: Developmental or cognitive impairment (,10th percentile of the control distribution) and/or new onset of caregiver-reported behavior problems occurred in 53% of case patients compared with 20% of the patients in the control group (odds ratio 4.5; 95% CI: 2.4 to 8.6; P, .001). In case patients, developmental or cognitive impairment at the 12-month assessment was associated with HIV-positive status and short stature at presentation, more prolonged fever and coma during admission, and severe atrophy or multifocal abnormalities being found on MRI at the 1-month assessment. CONCLUSIONS: One-half of survivors of CM were neurodevelopmentally impaired at the 1-year assessment. With these results, we support prevention trials of acute, neuroprotective interventions and the allocation of resources to evaluation, education, and rehabilitation efforts to reduce the significant long-term burden of CM-associated impairments on families and their communities.

Original languageEnglish (US)
Article numbere20181026
JournalPediatrics
Volume143
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Cerebral Malaria
Survivors
Morbidity
Caregivers
Control Groups
Resource Allocation
Coma
Malaria
Atrophy
Fever
Rehabilitation
Odds Ratio
HIV
Interviews
Education
Mortality
Incidence

PubMed: MeSH publication types

  • Journal Article

Cite this

Langfitt, J. T., McDermott, M. P., Brim, R., Mboma, S., Potchen, M. J., Kampondeni, S. D., ... Taylor, T. E. (2019). Neurodevelopmental impairments 1 year after cerebral malaria. Pediatrics, 143(2), [e20181026]. https://doi.org/10.1542/peds.2018-1026

Neurodevelopmental impairments 1 year after cerebral malaria. / Langfitt, John T.; McDermott, Michael P.; Brim, Rachel; Mboma, Sebastian; Potchen, Michael J.; Kampondeni, Sam D.; Seydel, Karl B.; Semrud-Clikeman, Margaret E; Taylor, Terrie E.

In: Pediatrics, Vol. 143, No. 2, e20181026, 01.02.2019.

Research output: Contribution to journalArticle

Langfitt, JT, McDermott, MP, Brim, R, Mboma, S, Potchen, MJ, Kampondeni, SD, Seydel, KB, Semrud-Clikeman, ME & Taylor, TE 2019, 'Neurodevelopmental impairments 1 year after cerebral malaria', Pediatrics, vol. 143, no. 2, e20181026. https://doi.org/10.1542/peds.2018-1026
Langfitt JT, McDermott MP, Brim R, Mboma S, Potchen MJ, Kampondeni SD et al. Neurodevelopmental impairments 1 year after cerebral malaria. Pediatrics. 2019 Feb 1;143(2). e20181026. https://doi.org/10.1542/peds.2018-1026
Langfitt, John T. ; McDermott, Michael P. ; Brim, Rachel ; Mboma, Sebastian ; Potchen, Michael J. ; Kampondeni, Sam D. ; Seydel, Karl B. ; Semrud-Clikeman, Margaret E ; Taylor, Terrie E. / Neurodevelopmental impairments 1 year after cerebral malaria. In: Pediatrics. 2019 ; Vol. 143, No. 2.
@article{f725d8fb2c3c49308550bcb63842ccbb,
title = "Neurodevelopmental impairments 1 year after cerebral malaria",
abstract = "BACKGROUND AND OBJECTIVES: Cerebral malaria (CM) causes significant mortality and morbidity in sub-Saharan African children. Reliable morbidity estimates are scarce because of methodological variability across studies. We describe the incidence, course, and severity of neurodevelopmental impairments in survivors of CM and the associated patient characteristics to inform epidemiologic estimates of malaria morbidity rates and prevention and treatment efforts. METHODS: We conducted an exposure-control study of 85 survivors of CM and 100 age-matched patients in a control group who were enrolled at hospital discharge and assessed after 1, 6, and 12 months using caregiver interviews and standardized developmental, cognitive, and behavioral measures. RESULTS: Developmental or cognitive impairment (,10th percentile of the control distribution) and/or new onset of caregiver-reported behavior problems occurred in 53{\%} of case patients compared with 20{\%} of the patients in the control group (odds ratio 4.5; 95{\%} CI: 2.4 to 8.6; P, .001). In case patients, developmental or cognitive impairment at the 12-month assessment was associated with HIV-positive status and short stature at presentation, more prolonged fever and coma during admission, and severe atrophy or multifocal abnormalities being found on MRI at the 1-month assessment. CONCLUSIONS: One-half of survivors of CM were neurodevelopmentally impaired at the 1-year assessment. With these results, we support prevention trials of acute, neuroprotective interventions and the allocation of resources to evaluation, education, and rehabilitation efforts to reduce the significant long-term burden of CM-associated impairments on families and their communities.",
author = "Langfitt, {John T.} and McDermott, {Michael P.} and Rachel Brim and Sebastian Mboma and Potchen, {Michael J.} and Kampondeni, {Sam D.} and Seydel, {Karl B.} and Semrud-Clikeman, {Margaret E} and Taylor, {Terrie E.}",
year = "2019",
month = "2",
day = "1",
doi = "10.1542/peds.2018-1026",
language = "English (US)",
volume = "143",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "2",

}

TY - JOUR

T1 - Neurodevelopmental impairments 1 year after cerebral malaria

AU - Langfitt, John T.

AU - McDermott, Michael P.

AU - Brim, Rachel

AU - Mboma, Sebastian

AU - Potchen, Michael J.

AU - Kampondeni, Sam D.

AU - Seydel, Karl B.

AU - Semrud-Clikeman, Margaret E

AU - Taylor, Terrie E.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - BACKGROUND AND OBJECTIVES: Cerebral malaria (CM) causes significant mortality and morbidity in sub-Saharan African children. Reliable morbidity estimates are scarce because of methodological variability across studies. We describe the incidence, course, and severity of neurodevelopmental impairments in survivors of CM and the associated patient characteristics to inform epidemiologic estimates of malaria morbidity rates and prevention and treatment efforts. METHODS: We conducted an exposure-control study of 85 survivors of CM and 100 age-matched patients in a control group who were enrolled at hospital discharge and assessed after 1, 6, and 12 months using caregiver interviews and standardized developmental, cognitive, and behavioral measures. RESULTS: Developmental or cognitive impairment (,10th percentile of the control distribution) and/or new onset of caregiver-reported behavior problems occurred in 53% of case patients compared with 20% of the patients in the control group (odds ratio 4.5; 95% CI: 2.4 to 8.6; P, .001). In case patients, developmental or cognitive impairment at the 12-month assessment was associated with HIV-positive status and short stature at presentation, more prolonged fever and coma during admission, and severe atrophy or multifocal abnormalities being found on MRI at the 1-month assessment. CONCLUSIONS: One-half of survivors of CM were neurodevelopmentally impaired at the 1-year assessment. With these results, we support prevention trials of acute, neuroprotective interventions and the allocation of resources to evaluation, education, and rehabilitation efforts to reduce the significant long-term burden of CM-associated impairments on families and their communities.

AB - BACKGROUND AND OBJECTIVES: Cerebral malaria (CM) causes significant mortality and morbidity in sub-Saharan African children. Reliable morbidity estimates are scarce because of methodological variability across studies. We describe the incidence, course, and severity of neurodevelopmental impairments in survivors of CM and the associated patient characteristics to inform epidemiologic estimates of malaria morbidity rates and prevention and treatment efforts. METHODS: We conducted an exposure-control study of 85 survivors of CM and 100 age-matched patients in a control group who were enrolled at hospital discharge and assessed after 1, 6, and 12 months using caregiver interviews and standardized developmental, cognitive, and behavioral measures. RESULTS: Developmental or cognitive impairment (,10th percentile of the control distribution) and/or new onset of caregiver-reported behavior problems occurred in 53% of case patients compared with 20% of the patients in the control group (odds ratio 4.5; 95% CI: 2.4 to 8.6; P, .001). In case patients, developmental or cognitive impairment at the 12-month assessment was associated with HIV-positive status and short stature at presentation, more prolonged fever and coma during admission, and severe atrophy or multifocal abnormalities being found on MRI at the 1-month assessment. CONCLUSIONS: One-half of survivors of CM were neurodevelopmentally impaired at the 1-year assessment. With these results, we support prevention trials of acute, neuroprotective interventions and the allocation of resources to evaluation, education, and rehabilitation efforts to reduce the significant long-term burden of CM-associated impairments on families and their communities.

UR - http://www.scopus.com/inward/record.url?scp=85061098341&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061098341&partnerID=8YFLogxK

U2 - 10.1542/peds.2018-1026

DO - 10.1542/peds.2018-1026

M3 - Article

VL - 143

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 2

M1 - e20181026

ER -